Yanagiya Masahiro, Matsumoto Jun, Miura Tamaki, Horiuchi Hajime
Department of General Thoracic Surgery, NTT Medical Center Tokyo, Tokyo, Japan.
Department of Diagnostic Pathology, NTT Medical Center Tokyo, Tokyo, Japan.
AME Case Rep. 2017 Nov 30;1:8. doi: 10.21037/acr.2017.11.02. eCollection 2017.
Solitary fibrous tumors of the pleura (SFTPs) are rare spindle cell neoplasms. The standard treatment is complete resection, but this may be challenging if the tumor is extremely large and originates from the diaphragm. We experienced a case of a giant solitary fibrous tumor originating from the diaphragm. A 74-year-old man presented with an asymptomatic giant mass on the right diaphragm suspicious of a solitary fibrous tumor. We performed a subcostal incision following posterolateral thoracotomy for complete resection. This surgical approach provided a better field around the diaphragm and facilitated radical and safe complete resection. The pathological diagnosis was a malignant solitary fibrous tumor. The patient survived for 1 year postoperatively without recurrence. We conclude that extended thoracotomy combined with a subcostal incision is a useful approach for surgical removal of giant tumors of the diaphragm.
胸膜孤立性纤维瘤(SFTPs)是罕见的梭形细胞肿瘤。标准治疗方法是完整切除,但如果肿瘤极大且起源于膈肌,这可能具有挑战性。我们遇到了一例起源于膈肌的巨大孤立性纤维瘤病例。一名74岁男性在右侧膈肌出现一个无症状的巨大肿块,怀疑为孤立性纤维瘤。我们在进行后外侧开胸术后采用肋下切口进行完整切除。这种手术方法在膈肌周围提供了更好的视野,便于进行根治性且安全的完整切除。病理诊断为恶性孤立性纤维瘤。患者术后存活1年,无复发。我们得出结论,扩大开胸术联合肋下切口是手术切除巨大膈肌肿瘤的一种有用方法。