Wada Ami, Furuhata Yoshiaki, Yanagiya Masahiro, Nakajima Jun, Hori Chisa, Bae Yuan, Kumasaka Toshio
Department of Thoracic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.
Kyobu Geka. 2024 Sep;77(9):679-683.
A 41-year-old asymptomatic male with no significant medical history had a heterogenous cystic tumor with a diameter of 5.1 cm containing fatty density in the anterior mediastinum and a nearby homogeneous enhancing nodule with a diameter of 2.0 cm were observed on chest computed tomography( CT). A malignant teratoma with mediastinal lymph node metastasis was suspected preoperatively. The tumor was completely removed via median sternotomy, with concomitant resection of the lung, pericardium, and right phrenic nerve. Postoperative pathological examination revealed a large mature cystic teratoma, 6.0 cm in diameter, and a small nodule, 3.7 cm in diameter, diagnosed as stageⅠ, type B2 thymoma. The postoperative course was uneventful, with no recurrence 30 months later. The simultaneous occurrence of mature teratoma and stageⅠthymoma is extremely rare. When suspecting a teratoma with small satellite nodules preoperatively, consideration of concurrent small thymoma is suggested.
一名41岁无症状男性，无重大病史，胸部计算机断层扫描（CT）显示前纵隔有一个直径5.1 cm的异质性囊性肿瘤，内含脂肪密度，附近还有一个直径2.0 cm的均匀强化结节。术前怀疑为伴有纵隔淋巴结转移的恶性畸胎瘤。通过正中胸骨切开术将肿瘤完全切除，同时切除了肺、心包和右膈神经。术后病理检查显示一个直径6.0 cm的大成熟囊性畸胎瘤和一个直径3.7 cm的小结节，诊断为Ⅰ期B2型胸腺瘤。术后病程顺利，30个月后无复发。成熟畸胎瘤与Ⅰ期胸腺瘤同时发生极为罕见。术前怀疑为伴有小卫星结节的畸胎瘤时，建议考虑合并小胸腺瘤的可能。
