Tao H, Yamashita M, Aoe M, Okabe K, Date H, Doihara H, Ando A, Harada Y, Hashizume H, Shimizu N
Second Department of Surgery, Okayama University, Japan.
Kyobu Geka. 1998 Aug;51(9):785-8.
A 15-year-old female was admitted because of the superior mediastinum mass on chest X-rays and sensory loss of ulnar side of the left arm. Computed tomographic scanning and magnetic resonance imaging revealed that the tumor was dumbbell-shaped and invaded the vertebral canal through the intervertebral foramen between C 7 and Th 1. At first laminectomy of vertebrae (C 6-Th 1) was made in a prone position and intra-spinal portion of the tumor was resected. Then the patient was placed in a supine position and the chest was opened by left hemicollar incision and sternotomy to the 2nd intercostal space. The tumor was divided into two parts at the level of 1st rib and completely removed. The pathological diagnosis was schwannoma. This procedure is safe and useful for dumbbell type tumor located in superior mediastinum, especially in case of large tumor from neck to the thoracic cavity.
一名15岁女性因胸部X线显示上纵隔肿块及左臂尺侧感觉丧失入院。计算机断层扫描和磁共振成像显示肿瘤呈哑铃形，通过C7和T1之间的椎间孔侵入椎管。首先在俯卧位行椎板切除术（C6 - T1），切除肿瘤的椎管内部分。然后患者改为仰卧位，经左半颈切口和胸骨切开至第二肋间空间打开胸腔。在第一肋骨水平将肿瘤分为两部分并完全切除。病理诊断为神经鞘瘤。该手术对于位于上纵隔的哑铃型肿瘤是安全且有效的，尤其是对于从颈部延伸至胸腔的大型肿瘤。
