Nagaoka H, Tashiro T, Hirai K, Yamasaki T, Masuda M, Nagai H, Nasu M
Second Department of Internal Medicine, Oita Medical University, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Jul;32(7):694-9.
A 65-year-old man was admitted to Oita Medical University Hospital with complaints of right back pain, diplopia and vertigo. A tumor, 33 x 25 mm, was found on the right lateral chest wall on admission. Chest X-ray film and chest CT scan showed a tumor, 50 x 30 mm, in the right posterior mediastinum. The chest wall tumor was diagnosed as malignant hemangiopericytoma by biopsy, and the same diagnosis was made for the mediastinal lesion by aspiration cytology. Brain MRI showed a mass at the skull base, which was found to be a metastatic bone tumor from the mediastinal malignant hemangiopericytoma. Abdominal CT scan showed a massive tumor, 65 x 60 mm, in the right lobe of the liver. The liver tumor was diagnosed as hepatocellular carcinoma by biopsy. Combination chemotherapy, employing cyclophosphamide, vincristine, pirarubicin and dacarbazine (DYVADIC), in conjunction with radiation therapy, produced no response. The patient died 5 months after admission. Malignant hemangiopericytoma arising from the mediastinum is uncommon. Thus, the clinical features of our case, as well as those of previously reported cases in Japan, are discussed herein.
一名65岁男性因右侧背痛、复视和眩晕入住大分医科大学医院。入院时在右侧胸壁发现一个33×25毫米的肿瘤。胸部X线片和胸部CT扫描显示右后纵隔有一个50×30毫米的肿瘤。胸壁肿瘤经活检诊断为恶性血管外皮细胞瘤,纵隔病变经细针穿刺细胞学检查也做出同样诊断。脑部MRI显示颅底有一个肿块,发现是纵隔恶性血管外皮细胞瘤转移所致的骨肿瘤。腹部CT扫描显示肝脏右叶有一个65×60毫米的巨大肿瘤。肝脏肿瘤经活检诊断为肝细胞癌。采用环磷酰胺、长春新碱、吡柔比星和达卡巴嗪(DYVADIC)联合化疗并结合放疗,未取得疗效。患者入院5个月后死亡。纵隔起源的恶性血管外皮细胞瘤并不常见。因此,本文讨论了我们病例的临床特征以及日本之前报道病例的临床特征。