Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Department of General Thoracic Surgery, Red Cross Hospital, Nagano, Japan.
Thorac Cancer. 2024 Nov;15(33):2395-2398. doi: 10.1111/1759-7714.15467. Epub 2024 Oct 8.
Leiomyosarcoma is a soft-tissue sarcoma that accounts for less than 1% of all malignant tumors. Furthermore, leiomyosarcoma accounts for 6% of all soft tissue sarcomas, and leiomyosarcoma of azygos vein origin is extremely rare. In this report, we describe a case of leiomyosarcoma derived from an azygos vein that was completely resected. A 78-year-old male patient was incidentally found to have a mediastinal mass during a computed tomography (CT) scan performed for the evaluation of prostate cancer. Bronchoscopic needle biopsy revealed the mass to be a leiomyosarcoma. Preoperative contrast-enhanced CT demonstrated a filling defect in the azygos vein, suggesting the tumor's origin from this structure. Video-assisted thoracoscopic surgery (VATS) was performed to resect the mediastinal tumor. The tumor was found to have minimal adhesions to surrounding tissues and no evidence of local invasion, although findings suggested it originated from the azygos vein. Consequently, en bloc resection of the azygos vein was performed. Postoperative histopathological examination confirmed the diagnosis of leiomyosarcoma originating from the azygos vein, and complete resection was performed.
平滑肌肉瘤是一种软组织肉瘤，占所有恶性肿瘤的不到 1%。此外，平滑肌肉瘤占所有软组织肉瘤的 6%，而源自奇静脉的平滑肌肉瘤极为罕见。本报告描述了一例完全切除的源自奇静脉的平滑肌肉瘤病例。一名 78 岁男性患者因前列腺癌评估而行计算机断层扫描（CT）检查时偶然发现纵隔肿块。支气管镜针吸活检显示肿块为平滑肌肉瘤。术前增强 CT 显示奇静脉充盈缺损，提示肿瘤源自该结构。为切除纵隔肿瘤而行电视辅助胸腔镜手术（VATS）。发现肿瘤与周围组织仅有轻微粘连，无局部侵犯的证据，但提示起源于奇静脉。因此，行奇静脉整块切除术。术后组织病理学检查证实了源自奇静脉的平滑肌肉瘤的诊断，并进行了完全切除。
