Okamoto Minoru, Tanaka Mutsuo, Tamori Yasuhiro, Haga Yoshio, Murayama Toshihiko
Department of Cardiovascular Surgery, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuou-ku, Kumamoto, 860-0008, Japan.
Gen Thorac Cardiovasc Surg. 2013 Dec;61(12):723-7. doi: 10.1007/s11748-012-0186-0. Epub 2012 Nov 28.
Although thymomas are the most common anterior mediastinal neoplasm, those causing cardiac tamponade are unusual. To the best of our knowledge, only 13 cases have been proven in the English literature We report thymoma in a 66-year old man that caused cardiac tamponade, for which he underwent an emergency operation. On admission, he presented in a shocked state; his echocardiography results revealed pericardial effusion. Computed tomography scan indicated a thymoma infiltrating the right lung. Initially, pericardial drainage was performed through puncture; however, cardiac tamponade recurred next day. Pericardial drainage, thymectomy, and pericardiectomy were performed, but the tumor was incompletely resected. On postoperative day 2, right upper lobectomy was attempted but discontinued because of the impossibility to manipulate the pulmonary hilum, which was suspected to have tumor infiltration. He was discharged on the 27th day after the first operation, is alive at 10 months after surgery, and is under chemotherapy.
胸腺瘤是最常见的前纵隔肿瘤,但导致心脏压塞的胸腺瘤并不常见。据我们所知,英文文献中仅证实有13例。我们报告1例66岁男性胸腺瘤导致心脏压塞,为此他接受了急诊手术。入院时,他处于休克状态;超声心动图结果显示心包积液。计算机断层扫描显示胸腺瘤侵犯右肺。最初,通过穿刺进行心包引流;然而,第二天心脏压塞复发。进行了心包引流、胸腺切除术和心包切除术,但肿瘤切除不完全。术后第2天,尝试行右上叶切除术,但因怀疑肺门有肿瘤浸润而无法操作肺门,手术中断。他在首次手术后第27天出院,术后10个月仍存活,正在接受化疗。