Fujino S, Nojima T, Asakura S, Onoe M, Watarida S, Mori A
Second Department of Surgery, Shiga University of Medical Science, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Aug;39(8):1188-93.
We would like to report on a case of thymic carcinoma that could be completely resected supported by extracorporeal circulation. A 53-year-old female complaining of severe coughing and hoarseness was admitted to our hospital. Her chest X-ray film revealed an abnormal shadow in the upper mediastinum and an elevation of the left diaphragm. Chest CT and MRI showed an anterior mediastinal mass that invaded the main pulmonary artery. The preoperative histological diagnosis of thymoma was made by mediastinoscopic specimen. After 50 Gy irradiation, surgery was performed. During the operation, after resection of the left brachiocephalic vein and a part of the upper lobe of the left lung, the tumor was detached from the wall of the aorta and resected with the invaded part of the pulmonary artery supported by cardiopulmonary bypass. Reconstruction of the pulmonary wall defect was accomplished with Xenomedica. The final pathological diagnosis was thymic adenosquamous carcinoma. The postoperative course has been uneventful 24 months after surgery. Extracorporeal circulation is a useful technique in operations involving malignant diseases when complete resection is able to be accomplished.
我们报告一例可在体外循环支持下完整切除的胸腺癌病例。一名53岁女性因严重咳嗽和声音嘶哑入院。胸部X线片显示上纵隔异常阴影及左膈抬高。胸部CT和MRI显示前纵隔肿物侵犯主肺动脉。术前通过纵隔镜标本作出胸腺瘤的组织学诊断。经过50 Gy放疗后进行手术。术中，在切除左头臂静脉及左肺上叶一部分后，在体外循环支持下将肿瘤从主动脉壁分离，并连同肺动脉受侵部分一并切除。用Xenomedica完成肺壁缺损重建。最终病理诊断为胸腺腺鳞癌。术后24个月病情平稳。当能够实现完整切除时，体外循环是涉及恶性疾病手术中的一项有用技术。
