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良性但终末期:巨大胸壁脂肪瘤致心肺崩溃。

Benign but Terminal: Cardiopulmonary Collapse from a Massive Chest Wall Lipoma.

机构信息

SUNY Upstate Medical University, Syracuse, NY, USA.

出版信息

J Investig Med High Impact Case Rep. 2020 Jan-Dec;8:2324709620949293. doi: 10.1177/2324709620949293.

Abstract

Lipomas are the most common benign soft tissue tumor. Yet, strikingly simple tumors can become problematic when compounded by odd characteristics such as size and location. We report the case of a 53-year-old male who developed complete right lung collapse secondary to a large right-sided chest wall lipoma with accelerated growth in the past 6 months. Bronchoscopy revealed extrinsic compression of the right mainstem bronchus. Histopathology of the soft tissue mass was suggestive of a lipoma. The mass was not amenable to surgery due to a high risk of mortality from his underlying comorbidities. His hospital stay was complicated by progressive end-stage restrictive lung disease necessitating intubation and eventually a tracheostomy, recurrent pneumonias, multiorgan dysfunction, and his eventual demise. We highlight a rare presentation of an unchecked lipoma, which ultimately led to the death of our patient. Simple lipomas show insidious growth and can remain asymptomatic until they reach a large size. Chest wall tumors should be considered malignant until proven otherwise by excisional biopsy. This reiterates the need to treat all chest wall tumors with wide resection in order to provide the best chance for cure.

摘要

脂肪瘤是最常见的良性软组织肿瘤。然而,当简单的肿瘤变得复杂,例如大小和位置不同寻常时,就会出现问题。我们报告了一例 53 岁男性的病例,他因过去 6 个月内快速生长的大型右侧胸壁脂肪瘤导致完全性右侧肺不张。支气管镜检查显示右主支气管外压。软组织肿块的组织病理学提示为脂肪瘤。由于潜在的合并症导致死亡率高,肿块无法进行手术。他的住院治疗因进行性终末期限制性肺病而复杂化,需要插管,最终进行气管切开术,反复发生肺炎、多器官功能障碍,最终导致他死亡。我们强调了一种罕见的未控制的脂肪瘤表现,这最终导致了我们患者的死亡。简单的脂肪瘤生长隐匿,在长到很大之前可能一直无症状。胸壁肿瘤应被视为恶性肿瘤,除非通过切除活检证实为良性。这再次强调了需要通过广泛切除来治疗所有胸壁肿瘤,以提供最佳治愈机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f59d/7436776/60eb31db5aa2/10.1177_2324709620949293-fig1.jpg

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