Otake Sotaro, Oyama Takahiko, Murakami Hiroaki, Horiguchi Julian, Fukutomi Toshinori, Kato Ryoichi
Department of Thoracic Surgery, Tokyo Medical Center, Tokyo, Japan.
Kyobu Geka. 2023 Apr;76(4):320-323.
A 30-year-old woman who presented loss of consciousness was diagnosed as having large anterior mediastinal tumor. Computed tomography (CT) showed a 17.0×13.0×7.3 cm cystic mass with internal calcification in the anterior mediastinum that was markedly compressing the heart, great vessels, trachea and bronchi. A mature cystic teratoma was suspected, and the mediastinal tumor was resected through a median sternotomy. At the induction of anesthesia to prevent the development of the respiratory and circulatory collapse, the patient was consciously intubated under the right lateral decubitus position while preparing for percutaneous cardiopulmonary support by cardiac surgeons, and the surgery was safely performed. The tumor was pathologically diagnosed as a mature cystic teratoma, and symptoms such as loss of consciousness have disappeared.
一名30岁出现意识丧失的女性被诊断为患有巨大前纵隔肿瘤。计算机断层扫描(CT)显示前纵隔有一个17.0×13.0×7.3 cm的囊性肿块,内部有钙化,该肿块明显压迫心脏、大血管、气管和支气管。怀疑为成熟囊性畸胎瘤,通过正中胸骨切开术切除纵隔肿瘤。在麻醉诱导时,为防止呼吸和循环衰竭的发生,患者在右侧卧位下清醒插管,同时心脏外科医生准备经皮心肺支持,手术安全进行。肿瘤经病理诊断为成熟囊性畸胎瘤,意识丧失等症状已消失。