Division of Chest Surgery, Department of Surgery, Toho University School of Medicine, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
Department of Surgical Pathology, Toho University School of Medicine, 6-11-1, Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan.
J Cardiothorac Surg. 2021 Oct 20;16(1):310. doi: 10.1186/s13019-021-01690-w.
The indications for surgical resection concerning multiple bilateral neurofibromas in the superior mediastinum remain controversial, because vascular injury or development of postoperative Horne syndrome are concerned.
A 60-year-old woman presented with multiple nodules in her right neck and bilateral chest cavity tops which indicated neurofibromatosis. The thoracic masses grew slowly over 9 years, and she then underwent a 2-stage resection starting with the left to right side. Bilateral tumors were completely removed via video-assisted thoracic surgery. The patient's postoperative course was uneventful, without postoperative Horner syndrome.
To the best of our knowledge, this is the first case of multiple bilateral superior mediastinal neurofibromas resected from the pulmonary apices via thoracoscopy. We selected a minimally invasive pure video-assisted thoracoscopic surgery approach and enucleated some tumors to avoid nerve injury. This approach may be safe and useful for multiple neurofibromas in patients with neurofibromatosis.
由于涉及到血管损伤或术后霍纳综合征的发生，对于多发双侧神经纤维瘤在纵隔上部的手术切除指征仍存在争议。
一位 60 岁的女性因右侧颈部和双侧胸腔顶部的多个结节就诊，这些结节提示患有神经纤维瘤病。胸内肿块在 9 年内缓慢生长，随后她接受了 2 期手术切除，先从左侧开始，然后再到右侧。通过胸腔镜手术完全切除了双侧肿瘤。患者术后恢复顺利，没有发生术后霍纳综合征。
据我们所知，这是首例通过胸腔镜从肺尖切除多发双侧纵隔上部神经纤维瘤的病例。我们选择了一种微创的纯电视胸腔镜手术方法，通过剜除一些肿瘤来避免神经损伤。这种方法对于神经纤维瘤病患者的多发性神经纤维瘤可能是安全且有用的。
