Sakamaki Yasushi, Yasukawa Motoaki, Kido Tetsuo
Department of Chest Surgery, Osaka Police Hospital, Kitayamacho 10-31, Tennoji, Osaka, 543-8502, Japan.
Gen Thorac Cardiovasc Surg. 2008 Oct;56(10):509-11. doi: 10.1007/s11748-008-0282-3. Epub 2008 Oct 15.
An asymptomatic 42-year-old man was diagnosed with a posterior mediastinal mass, most likely a nonfunctioning, benign, neurogenic tumor for which thoracoscopic surgery was initially indicated. However, the systemic blood pressure rapidly increased to a critical level immediately after starting the surgical manipulation of the tumor, which was suggestive of a hyperfunctioning pheochromocytoma. The tumor was removed after controlling the blood pressure and was histologically diagnosed as a pheochromocytoma. The patient had an uneventful course, and the tumor was proven to be sporadic through further postoperative investigations. The possibility of extraadrenal pheochromocytoma should be considered in the preoperative diagnosis of an intrathoracic paraaortic tumor, even in an asymptomatic patient.
一名42岁无症状男性被诊断为后纵隔肿块，很可能是无功能的良性神经源性肿瘤，最初建议行胸腔镜手术。然而，在开始对肿瘤进行手术操作后，全身血压迅速升至临界水平，提示为功能亢进性嗜铬细胞瘤。在控制血压后切除肿瘤，组织学诊断为嗜铬细胞瘤。患者病程顺利，术后进一步检查证实肿瘤为散发性。即使是无症状患者，在术前诊断胸内主动脉旁肿瘤时也应考虑肾上腺外嗜铬细胞瘤的可能性。
