Ichinose Junji, Nakahara Kazuki, Kina Satsuki, Miyanaga Shigeki
Department of Thoracic Surgery, Tokyo Teishin Hospital, Tokyo, Japan.
Ann Thorac Cardiovasc Surg. 2011;17(4):408-10. doi: 10.5761/atcs.cr.10.01553.
We report our experience with an unusual case of sclerosing hemangioma (SH) that formed a pedunculated mass protruding into the thoracic cavity. A pulmonary tumor was found in a 60-year-old female during the medical examination. Computed tomography showed a 19 × 17-mm nodule with a clear border and smooth margin contiguous with the diaphragm in the right S8 segment. Uneven enhancement following contrast medium administration was observed. We performed a 3-port thoracoscopic wedge resection of the right lower lobe. We observed a yellow pedunculated tumor protruding from the diaphragmatic surface of the right lower lobe. The surface of the tumor was smooth and encapsulated. Microscopically, we diagnosed it as a SH. SHs usually exist adjacent to the visceral pleura, but rarely form pedunculated tumors protruding into the cavity as seen in this case. By thoracoscopic surgery, we successfully diagnosed and treated the patient in a minimally invasive manner. Since there have been reported cases of recurrence, we anticipate that periodic follow-up observations will be required.
我们报告了一例罕见的硬化性血管瘤(SH)病例,该肿瘤形成了一个带蒂肿物突入胸腔。在体检过程中,一名60岁女性被发现患有肺部肿瘤。计算机断层扫描显示,在右S8段有一个19×17毫米的结节,边界清晰,边缘光滑,与膈肌相邻。注射造影剂后观察到不均匀强化。我们进行了三孔胸腔镜右下叶楔形切除术。我们观察到一个黄色带蒂肿瘤从右下叶的膈肌表面突出。肿瘤表面光滑,有包膜。显微镜下,我们将其诊断为SH。SH通常位于脏层胸膜附近,但很少像本例这样形成突入腔内的带蒂肿瘤。通过胸腔镜手术,我们以微创方式成功诊断并治疗了该患者。由于已有复发病例报道,我们预计需要进行定期随访观察。