Tani Kengo, Kimura Daisuke, Matsuo Tsubasa, Saito Yoshiaki, Taima Kageaki, Kakehata Shinya, Kurose Akira, Minakawa Masahito
Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Aomori, 036-8562, Hirosaki, Japan.
Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Aomori, 036-8562, Hirosaki, Japan.
Surg Case Rep. 2023 Apr 13;9(1):59. doi: 10.1186/s40792-023-01638-3.
Giant mediastinal mature teratomas may cause airway obstruction or decreased venous return due to the mass effect. Preoperative stabilization of the respiratory and circulatory systems is important for perioperative management to safely perform surgery, including general anesthesia. However, to the best of our knowledge, there are only a few reports regarding the preoperative computed tomography (CT)-guided drainage of mediastinal tumors.
A 30-year-old woman was admitted to the emergency room with sudden dyspnea. CT findings revealed a giant cystic mass in the anterior mediastinum compressing the trachea and the right main bronchus. The patient was intubated and CT-guided drainage of the fluid content of the cyst was performed to decompress the airway obstruction. Thereafter, the mediastinal tumor was resected during elective surgery and pathologically diagnosed as a mature teratoma.
Rescue preoperative CT-guided drainage of a giant mediastinal mature teratoma allowed safe general anesthesia and surgery by releasing the airway obstruction.
巨大纵隔成熟畸胎瘤可能因占位效应导致气道梗阻或静脉回流减少。术前稳定呼吸和循环系统对于围手术期管理至关重要，以便安全地进行包括全身麻醉在内的手术。然而，据我们所知，关于术前计算机断层扫描（CT）引导下纵隔肿瘤引流的报道很少。
一名30岁女性因突发呼吸困难入住急诊室。CT检查发现前纵隔有一个巨大的囊性肿块，压迫气管和右主支气管。患者接受了气管插管，并在CT引导下对囊肿内容物进行引流，以解除气道梗阻。此后，在择期手术中切除纵隔肿瘤，病理诊断为成熟畸胎瘤。
术前通过CT引导对巨大纵隔成熟畸胎瘤进行抢救性引流，解除气道梗阻，从而实现了安全的全身麻醉和手术。
