Ichimanda M, Okada S, Kai T
Department of Thoracic Surgery, Arumeida Memorial Hospital, Oita, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Jun;39(6):938-42.
The hens' egg-sized tumor connecting from anterior mediastinum to the hilus by chest radiography and chest CT was noted in a 63 year old female who complained of facial swelling and cough. The defect of the thumb tip-sized shadow was noted in the superior vena cava by superior vena cavography, and polyp covered with white coating obstructing the right apical bronchus was noted by fibrotic bronchoscopy, and malignant finding was obtained by biopsy of this polyp. After midsternotomy, a mass invaded to the superior vena cava and the right upper lobe was resected, and then superior vena cava was reconstructed by using supported polytetrafluoroethylene. The resected specimen revealed that the tumor extended not only to the pulmonary parenchyma with polypoid growth into the lumina of bronchi but also to the superior vena cava with polypoid growth. The patient was discharged at the postoperative radiotherapy with 40 Gy, and he is still alive free from the disease 3 years and 11 months after operation.
一名63岁女性,主诉面部肿胀和咳嗽,胸部X线和胸部CT检查发现一个鸡蛋大小的肿瘤从前纵隔连接至肺门。上腔静脉造影显示上腔静脉有拇指尖大小的阴影缺损,纤维支气管镜检查发现有一个覆盖白色附着物的息肉阻塞右肺尖支气管,对该息肉活检发现恶性病变。经正中胸骨切开术后,切除了侵犯上腔静脉和右上叶的肿块,然后使用支撑型聚四氟乙烯重建上腔静脉。切除标本显示肿瘤不仅呈息肉样生长侵入支气管腔并累及肺实质,还呈息肉样生长累及上腔静脉。患者术后接受40 Gy的放射治疗后出院,术后3年11个月仍存活且无疾病复发。