Mansour Ziad, Neuville Agnès, Massard Gilbert
Department of Thoracic Surgery, Strasbourg University Hospital, Strasbourg, France.
Interact Cardiovasc Thorac Surg. 2010 Jan;10(1):122-4. doi: 10.1510/icvts.2009.216978. Epub 2009 Oct 15.
We report the case of a 35-year-old patient with an incidental finding of an asymptomatic large (9.5 cm in diameter) anterior mediastinal tumour. Radiological findings favoured the diagnosis of a benign mediastinal teratoma. During surgical resection, we found a tumour adhering to the surrounding tissues, and encompassing the innominate vein which was totally occluded. Total tumoural exeresis was performed as well as the double cross-section of the innominate vein. Postoperatively, there was no left upper limb swelling, probably because of a chronic occlusion of the innominate vein. The hospital stay was uneventful. Immunohistochemistry diagnosed a mediastinal 'epithelioid haemangioendothelioma', which is a tumour of vascular origin. We believe that the tumour took origin from the innominate vein and invaded the anterior mediastinum. After a simple radiological follow-up, the patient is in complete remission 30 months after the operation. We present the case of this patient with the iconography, along with a review of the available literature concerning mediastinal epithelioid haemangioendotheliomas.
我们报告了一例35岁患者，偶然发现一个无症状的巨大（直径9.5厘米）前纵隔肿瘤。影像学检查结果支持良性纵隔畸胎瘤的诊断。在手术切除过程中，我们发现肿瘤与周围组织粘连，并包绕完全闭塞的无名静脉。进行了肿瘤全切以及无名静脉的双切面处理。术后，左上肢没有出现肿胀，可能是因为无名静脉存在慢性闭塞。住院期间情况平稳。免疫组织化学诊断为纵隔“上皮样血管内皮瘤”，这是一种起源于血管的肿瘤。我们认为该肿瘤起源于无名静脉并侵犯了前纵隔。经过简单的影像学随访，患者术后30个月完全缓解。我们展示了该患者的影像学资料，并对有关纵隔上皮样血管内皮瘤的现有文献进行了综述。
