Nakajima J, Shindo G, Makuuchi H, Kawauchi M, Furuse A, Oka T
Department of Thoracic Surgery, University of Tokyo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Jan;38(1):171-7.
A forty-seven-year-old woman visited our hospital in March 1987 suffering from the local recurrence of the tumor. Her right 7th and 8th rib had been resected 2 years and 11 months before because of the malignant fibrous histiocytoma (MFH) originated from the right 7th rib. In May 1987, wide resection of the right lateral chest wall and partial resection of the right diaphragm were done. Dacron meshed silicon plate (Silastic) and musculocutaneous flap of the right latissimus dorsi were used to reconstruct the chest wall. Seven months after the second operation, local recurrence occurred again on the anterior chest wall, involving the right diaphragm and right lower lobe of the lung. In March 1988, extensive resection of the anterior chest wall with partial resection of the right diaphragm and the right lower lobe was followed by reconstruction of the chest wall by Silastic. The patient recovered uneventfully without any respiratory disturbances after both operations which included wide resection of the chest wall. Multiple pulmonary metastases were found 4 months after the operation, and she died of respiratory failure 7 months after the final operation. Although MFH was one of the most common sarcomas of the soft tissues, only one case of the MFH originated from the rib had been reported previously in this country. Silastic was proved to be a useful prosthesis for the reconstruction of widely resected chest wall.
一名47岁女性于1987年3月因肿瘤局部复发前来我院就诊。两年零十一个月前，她因起源于右侧第7肋骨的恶性纤维组织细胞瘤（MFH）接受了右侧第7、8肋骨切除术。1987年5月，进行了右侧胸壁广泛切除术及右侧膈肌部分切除术。使用涤纶网眼硅胶板（硅橡胶）和右侧背阔肌肌皮瓣重建胸壁。第二次手术后七个月，前胸壁再次出现局部复发，累及右侧膈肌和右肺下叶。1988年3月，在前胸壁广泛切除并部分切除右侧膈肌和右肺下叶后，用硅橡胶重建胸壁。两次包括胸壁广泛切除在内的手术后，患者恢复顺利，无任何呼吸功能障碍。术后四个月发现多处肺转移，最终手术后七个月，患者死于呼吸衰竭。尽管MFH是最常见的软组织肉瘤之一，但此前该国仅报道过一例起源于肋骨的MFH。事实证明，硅橡胶是广泛切除胸壁重建的有用假体。
