Maeda Sumiko, Takahashi Satomi, Koike Kaoru, Sato Masami
Department of Thoracic Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan.
Ann Thorac Cardiovasc Surg. 2011;17(4):394-6. doi: 10.5761/atcs.cr.10.01537.
We present the case of a 67-year-old male smoker with a posterior mediastinal hemangioma. Radiological findings revealed a dumbbell-shaped tumor with a neuroforaminal extension in the right paravertebral space. Under the preoperative diagnosis of a neurogenic tumor, surgery was performed using a combined anterior and posterior approach. During the thoracotomy, the tumor was found to be a hemangioma. We ligated the involved vessels before performing laminectomy, thus ensuring that complete tumor resection was achieved without massive bleeding in the spinal canal. Dumbbell-shaped hemangiomas are rare, and preoperative confirmation of the diagnosis is challenging. Thoracotomy before laminectomy is optimal for the resection of dumbbell-shaped tumors of the mediastinum, especially with marked vascularity, given that the initial thoracotomy procedures facilitate the subsequent laminectomy procedures.
我们报告一例67岁男性吸烟者，患有后纵隔血管瘤。影像学检查发现一个哑铃形肿瘤，向右侧椎旁间隙呈神经孔样延伸。术前诊断为神经源性肿瘤，采用前后联合入路进行手术。开胸手术中发现肿瘤为血管瘤。我们在进行椎板切除术之前结扎受累血管，从而确保在不发生椎管内大出血的情况下实现肿瘤的完整切除。哑铃形血管瘤较为罕见，术前确诊具有挑战性。对于纵隔哑铃形肿瘤，尤其是血管丰富的肿瘤，在椎板切除术之前先进行开胸手术是最佳的切除方式，因为最初的开胸手术操作有助于后续的椎板切除术。
