Miwa K, Taniguchi Y, Adachi Y, Haruki T, Nakamura H
Division of General Thoracic Surgery, Tottori University Hospital, Yonago, Japan.
Kyobu Geka. 2006 Nov;59(12):1115-8.
We report a case of a 64-year-old woman with an anterior mediastinal tumor on a chest computed tomography (CT) before operation of uterine cancer. After the radical surgery and a chemotherapy for uterine cancer, surgical resection of mediastinal tumor was performed in July 2005 because of gradually progression in tumor size. Under the median sternotomy, the tumor revealed intensive adhesion to the right lung and the left brachiocephalic vein. We performed a complete resection of the tumor with combined resection of adherent parts of them. The tumor was 9 x 8 cm in size, containing with yellow cream-like fluid and hair. Histologically, the tumor was diagnosed as a mature teratoma with the tissue of bone, digestive tract epithelium, bronchial epithelium and so on. In benign teratoma, it is not rare to perforate to the adjacent structures. So, we concluded if the mediastinal teratoma was suspected, long-term observation had the risk for adhesion and perforation to adjacent tissue, and in case of operation, we should keep in mind the possibility of combined resection of involved organs.
我们报告一例64岁女性病例，该患者在子宫癌手术前的胸部计算机断层扫描（CT）检查中发现前纵隔肿瘤。在子宫癌根治性手术及化疗后，由于肿瘤大小逐渐增大，于2005年7月对纵隔肿瘤进行了手术切除。在正中胸骨切开术下，肿瘤显示与右肺和左头臂静脉紧密粘连。我们对肿瘤进行了完整切除，并联合切除了与之粘连的部分。肿瘤大小为9×8 cm，内含黄色奶油样液体和毛发。组织学检查显示，肿瘤被诊断为成熟畸胎瘤，含有骨组织、消化道上皮、支气管上皮等。在良性畸胎瘤中，向相邻结构穿孔并不罕见。因此，我们得出结论，如果怀疑纵隔畸胎瘤，长期观察存在粘连和向相邻组织穿孔的风险，手术时应牢记联合切除受累器官的可能性。
