Okagawa Takehiko, Uchida Tatsuo, Suyama Motokazu
Department of Chest Surgery, Aichi Cancer Center, Aichi Hospital, 18 Kuriyado, Kake-machi, Okazaki, Aichi, 444-0011, Japan.
Gen Thorac Cardiovasc Surg. 2007 Dec;55(12):515-7. doi: 10.1007/s11748-007-0180-0. Epub 2007 Dec 11.
A 31-year-old woman was admitted to our hospital with sudden onset of chest pain. Chest radiography and computed tomography (CT) on admission showed an anterior mediastinal tumor with left pleural effusion, which was diagnosed as an inoperable malignant mediastinal tumor. However, 3 weeks after admission CT showed that the tumor was diminishing and the pleural effusion had disappeared without any treatment. CT-guided needle biopsy was performed, but diagnosis was impossible because most of the specimen was necrotic. A biopsy during video-assisted thoracic surgery was then performed. The intraoperative finding showed that the tumor was round, well mobilized, and did not invade adjacent structures. It was then assumed to be a benign teratoma that had been ruptured into the thoracic cavity. The operation was converted to a thoracotomy to resect it, but it could not be completely resected because of inflammatory adhesions to the mediastinum. Two months later, total thymectomy was performed through a median sternotomy because the tumor was pathologically diagnosed as a thymoma.
一名31岁女性因突发胸痛入院。入院时胸部X线和计算机断层扫描（CT）显示前纵隔肿瘤伴左侧胸腔积液，诊断为不可切除的恶性纵隔肿瘤。然而，入院3周后CT显示肿瘤缩小且胸腔积液未经任何治疗已消失。进行了CT引导下针吸活检，但由于大部分标本坏死无法确诊。随后在电视辅助胸腔镜手术中进行了活检。术中发现肿瘤呈圆形，活动良好，未侵犯相邻结构。当时推测为破裂进入胸腔的良性畸胎瘤。手术改为开胸切除，但由于与纵隔的炎性粘连无法完全切除。两个月后，因肿瘤病理诊断为胸腺瘤，通过正中胸骨切开术进行了全胸腺切除术。
