Hato Tai, Kaseda Kaoru, Harada Masahiko, Horio Hirotoshi
Department of General Thoracic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
Gen Thorac Cardiovasc Surg. 2011 Dec;59(12):812-4. doi: 10.1007/s11748-010-0769-6. Epub 2011 Dec 16.
We describe a 61-year-old woman with an anterior mediastinal paraganglioma. The patient complained of a chronic cough that had lasted about 6 months. Her chest computed tomography (CT) showed a highly enhanced mediastinal tumor in the aorticopulmonary window. We surgically resected this tumor thorough a left anterior thoracotomy. Although numerous feeding vessels and firm adhesions with the pericardium hindered the procedure, macroscopically complete resection was achieved. Postoperatively, the tumor was diagnosed as an aorticopulmonary paraganglioma. As these highly enhanced tumors in the anterior mediastinum on CT images are unusual, a differential diagnosis including mediastinal hemangioma, epithelioid hemangioendothelioma, Castleman's disease, choriocarcinoma, metastatic tumor (especially from renal cell carcinoma), and paraganglioma should be considered.
我们描述了一名患有前纵隔副神经节瘤的61岁女性。患者主诉持续约6个月的慢性咳嗽。她的胸部计算机断层扫描(CT)显示主动脉肺动脉窗有一个高度强化的纵隔肿瘤。我们通过左前开胸手术彻底切除了该肿瘤。尽管众多供血血管以及与心包的紧密粘连给手术带来了阻碍,但在肉眼下实现了完整切除。术后,该肿瘤被诊断为主动脉肺动脉副神经节瘤。由于CT图像上前纵隔这些高度强化的肿瘤较为罕见,应考虑包括纵隔血管瘤、上皮样血管内皮瘤、Castleman病、绒毛膜癌、转移瘤(尤其是肾细胞癌转移)和副神经节瘤在内的鉴别诊断。