Singh Jaswinder, Rana Sandeep Singh, Sharma Rajeshwar, Ghai Babita, Puri G D
Department of Cardiovascular and Thoracic Surgery, Military Hospital (Cardiothoracic Centre), Golibar Maidan, Pune, India.
Pediatr Surg Int. 2008 Jul;24(7):865-7. doi: 10.1007/s00383-008-2165-1. Epub 2008 May 6.
Mediastinal pheochromocytomas account for only a small fraction of mediastinal tumors. Most commonly, these tumors are located in posterior mediastinum. Increasing number of cases of pheochromocytomas is being reported from middle mediastinum. Excision of mediastinal paraganglioma is often hazardous because of its rich blood supply and tendency to involve surrounding structures. It can be a big challenge to manage asymptomatic cases of pheochromocytoma intraoperatively. It is imperative that these patients receive adequate alpha adrenergic and if necessary beta adrenergic blockade. Adequate preoperative preparation with alpha and beta blockers may not prevent serious intraoperative hypertension. We report a case of posterior mediastinal pheochromocytoma which was biochemically active preoperatively. We review the presentation, diagnosis and management of intrathoracic pheochromocytomas including cardiac pheochromocytomas.
纵隔嗜铬细胞瘤仅占纵隔肿瘤的一小部分。这些肿瘤最常见于后纵隔。越来越多的嗜铬细胞瘤病例报道来自中纵隔。纵隔副神经节瘤的切除往往具有危险性，因为其血供丰富且易累及周围结构。术中处理无症状嗜铬细胞瘤病例可能是一项巨大挑战。这些患者必须接受充分的α肾上腺素能阻滞，必要时接受β肾上腺素能阻滞。使用α和β受体阻滞剂进行充分的术前准备可能无法预防严重的术中高血压。我们报告一例术前生化检查有活性的后纵隔嗜铬细胞瘤病例。我们回顾了胸内嗜铬细胞瘤包括心脏嗜铬细胞瘤的临床表现、诊断和治疗。
