Nakamura Daisuke, Kobayashi Nobutaka, Miyazawa Masahisa, Satomi Hidetoshi, Ihara Nobumaro, Tsunoda Mayu
Department of Thoracic Surgery, Japanese Red Cross Society Nagano Hospital, 5-22-1 Wakasato, Nagano, Japan.
Department of Pathology, Japanese Red Cross Society Nagano Hospital, 5-22-1 Wakasato, Nagano, Japan.
J Surg Case Rep. 2021 May 6;2021(5):rjab168. doi: 10.1093/jscr/rjab168. eCollection 2021 May.
An angiolipoma is a benign tumor, and a primary mediastinal angiolipoma is extremely rare. Herein, we describe the presentation and management of a posterior mediastinal angiolipoma in a woman with loss of consciousness. Chest computed tomography (CT) revealed a contrast-enhancing mass in the right posterior mediastinum, with intercostal arterial blood supply identified on three-dimensional reconstruction CT (3D-CT). Magnetic resonance imaging revealed a fatty component. Pre-operative embolization of the supplying intercostal artery was performed to reduce intraoperative bleeding. Mass resection was performed using video-assisted thoracic surgery. Histopathology confirmed angiolipoma diagnosis. Although rare, a posterior mediastinum angiolipoma should be considered a possibility; 3D-CT and pre-operative embolization may be useful in the surgical treatment of hypervascular mediastinal tumors, such as angiolipomas.
血管脂肪瘤是一种良性肿瘤，而原发性纵隔血管脂肪瘤极为罕见。在此，我们描述了一名意识丧失女性后纵隔血管脂肪瘤的表现及治疗情况。胸部计算机断层扫描（CT）显示右后纵隔有一强化肿块，三维重建CT（3D-CT）显示有肋间动脉供血。磁共振成像显示有脂肪成分。为减少术中出血，对供血肋间动脉进行了术前栓塞。采用电视辅助胸腔镜手术进行了肿块切除术。组织病理学证实为血管脂肪瘤诊断。尽管罕见，但后纵隔血管脂肪瘤仍应被考虑；3D-CT和术前栓塞可能有助于高血供纵隔肿瘤（如血管脂肪瘤）的手术治疗。
