Section of General Thoracic Surgery, Duke University Medical Center, Durham, North Carolina; Department of General Thoracic Surgery, China-Japan Friendship Hospital, Chaoyang, Beijing, China.
Ann Thorac Surg. 2013 Aug;96(2):685-7. doi: 10.1016/j.athoracsur.2012.12.050.
A 52-year-old man complained of cough and hemoptysis for 1 month. Chest computed tomography scan revealed a 9 cm × 7 cm right lung mass invading the right inferior pulmonary vein and left atrium extensively, and the inferior pulmonary vein was completely occluded. Transsternal echocardiogram confirmed that the lesion invaded the apex of left atrium adjacent to the right pulmonary inferior vein. Positron emission tomography scan showed no other metastatic disease. Bronchoscopy with endobronchial biopsy demonstrated a low-grade squamous cell carcinoma. After 2 cycles of induction chemotherapy, he underwent resection with cardiopulmonary bypass. Postoperative pathology was sarcoma mixed with squamous carcinoma (10%), without lymph node metastasis. Both the bronchial and atrial margins were negative, pathology stage T4N0M0, IIIA. He recovered without postoperative complications, and went back to work 20 days after surgery. He received four cycles of subsequent chemotherapy, but a solitary brain metastasis was discovered 7 months later, and he died 9 months after surgery.
一位 52 岁男性因咳嗽和咯血 1 个月就诊。胸部 CT 扫描显示右肺 9cm×7cm 肿块广泛侵犯右下肺静脉和左心房，下肺静脉完全闭塞。经胸骨后超声心动图证实病变侵犯毗邻右下肺静脉的左心房心尖部。正电子发射断层扫描未显示其他转移病灶。支气管镜活检显示低级别鳞状细胞癌。行 2 周期诱导化疗后，患者接受体外循环肺切除术。术后病理示肉瘤伴鳞状细胞癌（10%），无淋巴结转移。支气管和心房切缘均为阴性，病理分期为 T4N0M0，ⅢA 期。患者术后无并发症恢复良好，术后 20 天返回工作岗位。随后接受了 4 周期化疗，但 7 个月后发现单发脑转移，术后 9 个月死亡。
