胸腺表皮样癌在心包腔内复发1例。

S Nagai, Y Okamura, H Ishihama, M Chimoto, Y Ikeda, K Shimada
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引用次数: 0

摘要

患者61岁,女,咳嗽、痰多,右肩胛骨疼痛,胸部x线及ct检查疑似前纵隔肿瘤。经细针活检诊断为胸腺癌。经胸骨正中切口开胸时,肿瘤粘附于左臂静脉、上腔静脉和心包膜,采用手法切除。经手术标本组织学检查诊断为中分化表皮样癌,组织学推测累及心包。患者术后接受放射治疗。术后1年肿瘤在心包腔内复发。尽管切除了复发的肿瘤并进行了抗癌化疗,但由于心脏周围肿瘤的增殖,患者死于心力衰竭。有一些报道表明,胸腺表皮样癌可能根据肿瘤的组织学分化对放射治疗有不同的反应。因此,在切除胸腺表皮样癌时,术中对切除标本粘附部分的病理检查和进一步切除是彻底切除胸腺癌的必要条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[A case of thymic epidermoid carcinoma recurred in the pericardial cavity].

A 61-year-old woman with cough and sputum and right scapular pain was referred to our hospital with a suspected anterior mediastinal tumor by Chest X-rays and CT-scan. The tumor was diagnosed as thymic cancer cytologically by fine needle biopsy. At the the thoracotomy via median sternotomy, the tumor adhered to left brachial vein, superior vena cava and pericardium and it was dissected by maneuver. It was diagnosed as moderately differentiated epidermoid carcinoma by histology of the surgical specimen and involvement of the pericardium was histologically presumed. The patient received postoperative radiation therapy. A year after operation, the tumor recurred in the pericardial cavity. Inspite of resection of the recurred tumor and an anticancer chemotherapy, the patient died of cardiac failure due to the proliferated tumor around the heart. There are some reports that epidermoid carcinoma of the thymus may have different responses to radiation therapy according to histologic tumor differentiations. At resection of epidermoid carcinoma of thymus, therefore, intraoperative pathologic examination of the adhesive part of excised specimen and additional resection were essential to resect thymic cancer radically.

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