Naomi Akira, Oyamatsu Yasunori, Narita Kunio, Nakayama Masao, Maeda Matsuyoshi
Department of Thoracic Surgery, Aichi Cancer Central Hospital, Nagoya, Japan.
Kyobu Geka. 2015 Jul;68(7):551-5.
Angiosarcoma has been reported as a rare case, having high potential of hematogeneous lung metastasis and then developing to pneumothorax with ease. The patient was a 74-year-old man afflicted with a malignant hemangio endothelioma (MHE) of the scalp. His MHE of the scalp was resected and skin grafting was made, then, he was administered docetaxel hydrate intravenously as adjuvant setting. Three years after, he complainted left chest pain and dyspnea, so his chest Xp was checked up and showed left pneumothorax. Chest computed tomography revealed multiple thin walled cavities of right and left lung and bullae with slightly thick walled cavity at apex legion of the left lung. We resected bullae with tumor of the left apex legion under video assisted thoracic surgery. After operation, He was administerd ricombinant interleukin-2 intravenously in order to control lung metastasis of the scalp, but his condition deteriorated and 6 months after pneumothorax he died. The average survival time from the 1st pneumothorax episode was only 4.7 months. He kept a good activities of daily living without reccurrence of pneumothorax by operation, so we thought that the operaion for pneumothorax with MHE was one option for therapy.
血管肉瘤是一种罕见病例,具有很高的血行性肺转移潜力,且容易发展为气胸。该患者为一名74岁男性,患有头皮恶性血管内皮瘤(MHE)。其头皮的MHE被切除并进行了皮肤移植,然后,作为辅助治疗,给他静脉注射了多西他赛。三年后,他出现左胸痛和呼吸困难,因此对其进行了胸部X光检查,结果显示为左侧气胸。胸部计算机断层扫描显示右肺和左肺有多个薄壁空洞以及左肺尖部有一个壁稍厚的大疱。我们在电视辅助胸腔镜手术下切除了左肺尖部带有肿瘤的大疱。术后,为了控制头皮的肺转移,给他静脉注射了重组白细胞介素-2,但他的病情恶化,气胸发生6个月后死亡。首次气胸发作后的平均生存时间仅为4.7个月。通过手术,他在日常生活中活动良好且气胸未复发,所以我们认为对伴有MHE的气胸进行手术是一种治疗选择。