Tanaka I, Masuda R, Inoue M, Kasahara D, Furuhata Y, Shimizu S, Takemura T
Department of Thoracic Surgery, Japanese Red Cross Medical Center, Tokyo.
Thorac Cardiovasc Surg. 1994 Feb;42(1):64-8. doi: 10.1055/s-2007-1016459.
A case of pulmonary leiomyosarcoma originating in the left pulmonary artery stem in a 28-year-old Japanese man is reported. The patient complained of recurrent hemoptysis. The diagnosis was made at exploratory thoracotomy. Two days following thoracotomy, under cardio-pulmonary bypass, the upper one-third of the pulmonary trunk and part of the right pulmonary artery stem were resected and left pneumonectomy was performed. A Dacron prosthetic 23 mm composite graft was inserted to replace the pulmonary trunk and a portion of the right pulmonary artery. Postoperative course was uneventful. The patient died about 8 months after surgery because of right lung metastases. In our review of surgically treated forty-eight cases, complete resection was performed in 11, incomplete resection in 23, and embolectomy in 6, whereas 8 were unresectable. A localisation often not allowing adequate resection of the tumor or the advanced stage of the tumor at surgery are considered the main causes of the poor prognosis of the pulmonary sarcoma.
报告了一例起源于一名28岁日本男性左肺动脉干的肺平滑肌肉瘤病例。患者主诉反复咯血。诊断是在开胸探查时做出的。开胸术后两天，在体外循环下，切除肺动脉干上三分之一及部分右肺动脉干，并进行了左肺切除术。插入一个23毫米的涤纶人工合成复合移植物以替代肺动脉干和部分右肺动脉。术后病程平稳。患者术后约8个月因右肺转移死亡。在我们对48例手术治疗病例的回顾中，11例行根治性切除，23例行不完全切除，6例行栓子切除术，8例无法切除。肿瘤定位常不允许对肿瘤进行充分切除或手术时肿瘤分期较晚被认为是肺肉瘤预后不良的主要原因。
