Ayabe Takanori, Matsuzaki Yasunori, Shimizu Tetsuya, Hara Masaki, Tomita Masaki, Yano Yoshikazu, Yano Mitsuhiro, Nakamura Kunihide, Ito Hiroshi, Nagaike Koki, Onitsuka Toshio
Department of Second Surgery, Faculty of Medicine, Miyazaki University, Japan.
Kyobu Geka. 2006 Aug;59(9):804-8.
A 68-year-old male was found an abnormal shadow on chest X-ray and was diagnosed as thymoma by computed tomography (CT)-guided needle biopsy. As the tumor invaded the aortic arch, left main pulmonary artery and the lung, thymectomy combined resection of the surrounding tissues was performed for the complete resection. The aortic arch was replaced with cardiovascular graft under cardiopulmonary bypass, with the aid of selective cerebral perfusion. The left pneumonectomy was performed because the tumor invaded to the left main pulmonary artery and to the lung parenchyma. Masaoka stage III and histologic type B2 were diagnosed according to the World Health Organization classification. The patient has been well without recurrence or metastasis after the surgery for 2 years. A complete resection of the thymoma invaded to great vessels should be performed to expect for the good curability and prognosis.
一名68岁男性在胸部X线检查时发现异常阴影，经计算机断层扫描（CT）引导下针吸活检诊断为胸腺瘤。由于肿瘤侵犯主动脉弓、左主肺动脉和肺，遂行胸腺切除术并联合切除周围组织以实现完整切除。在体外循环辅助下，借助选择性脑灌注，用心血管移植物替换主动脉弓。因肿瘤侵犯左主肺动脉和肺实质，故行左肺切除术。根据世界卫生组织分类诊断为Masaoka III期和组织学类型B2。该患者术后2年情况良好，无复发或转移。对于侵犯大血管的胸腺瘤，应进行完整切除以期望获得良好的治愈率和预后。
