Nishio S, Oda M, Matsumoto I, Tamura M, Shimizu Y, Watanabe G
Department of General and Cardiothoracic Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Kyobu Geka. 2010 May;63(5):426-9.
We report a case of anterior mediastinal lipoma. A 71-year-old female was admitted for cough. A fat density tumor from anterior mediastinum to left thoracic cavity was found by chest X-ray, chest computed tomography (CT) and magnetic resonance imaging (MRI). Defect of left dorsal diaphragm was suspected and there was a possibility that the tumor was connected to retroperitoneum. Under the preoperative diagnosis of a benign huge mediastinal lipoma, we conducted an operation. At 1st, we observed by thoracoscopy and made sure that the mass was primary anterior mediastinal tumor and not connected to retroperitoneum. Through the median sternotomy, we completely resected the tumor with thymus. The tumor showed 27 cm in diameter, and histopathological diagnosis of the tumor was benign lipoma. Lipoma of the mediastinum is very rare and about 0.3% of all mediastinal tumors. It is sometimes difficult to distinguish huge lipoma from liposarcoma only by clinical examinations such as CT scan or MRI. We evaluated the condition of the tumor by thoracoscopic observation, and the tumor was safely and completely resected by median sternotomy.
我们报告一例前纵隔脂肪瘤病例。一名71岁女性因咳嗽入院。胸部X线、胸部计算机断层扫描(CT)和磁共振成像(MRI)检查发现一个从前纵隔延伸至左胸腔的脂肪密度肿瘤。怀疑左膈背侧有缺损,且肿瘤有可能与腹膜后相连。在术前诊断为良性巨大纵隔脂肪瘤的情况下,我们进行了手术。首先,我们通过胸腔镜观察,确定肿块是原发性前纵隔肿瘤,且未与腹膜后相连。通过正中胸骨切开术,我们将肿瘤与胸腺一并完整切除。肿瘤直径达27厘米,肿瘤的组织病理学诊断为良性脂肪瘤。纵隔脂肪瘤非常罕见,约占所有纵隔肿瘤的0.3%。有时仅通过CT扫描或MRI等临床检查很难将巨大脂肪瘤与脂肪肉瘤区分开来。我们通过胸腔镜观察评估了肿瘤情况,并通过正中胸骨切开术安全、完整地切除了肿瘤。