Imai Kensuke, Ito Megumi, Kanetsuki Kazuma, Shimizu Koji, Suehiro Shoichi, Oda Teiji
Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Shimane University Faculty of Medicine, Izumo, Japan.
Kyobu Geka. 2015 Dec;68(13):1093-5.
79-year-old woman, who had undergone resection of a leiomyosarcoma of the inferior vena cava(IVC)[at 68 years old], was admitted to our hospital due to local recurrence of the leiomyosarcoma with extention into the right atrium (RA). She had progressive dyspnea and bilateral edema of the lower extremities. A computed tomography (CT) scan revealed a tumor that obstructed the IVC. A transthoracic echocardiography showed a large mobile right atrial mass. To prevent sudden death, a reoperation was performed. The tumor in the IVC and the RA was resected under deep hypothermic circulatory arrest. A postoperative CT scan showed stenosis of the IVC by residual tumor, and a Z-stent was therefore implanted in the IVC. Postoperative recovery was uneventful and the patient no longer showed any symptoms.
一名79岁女性,曾在68岁时接受下腔静脉平滑肌肉瘤切除术,因平滑肌肉瘤局部复发并蔓延至右心房而入住我院。她有进行性呼吸困难和双下肢水肿。计算机断层扫描(CT)显示有一个肿瘤阻塞了下腔静脉。经胸超声心动图显示右心房有一个大的可移动肿块。为防止猝死,进行了再次手术。在深低温循环停搏下切除了下腔静脉和右心房的肿瘤。术后CT扫描显示残留肿瘤导致下腔静脉狭窄,因此在下腔静脉植入了一个Z形支架。术后恢复顺利,患者不再有任何症状。