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Báo cáo y học: " Complete removal of heart-compressing large mediastinal lipoma : a case report"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Complete removal of heart-compressing large mediastinal lipoma : a case report. | Minematsu et al. Journal of Cardiothoracic Surgery 2010 5 48 http www.cardiothoracicsurgery.Org content 5 1 48 Jdfrs JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Co mplete removal of heart-compressing large mediastinal lipoma a case report Noritoshi Minematsu 1 Naoki Minato1 2 Keiji Kamohara1 and Takeshi Hakuba1 Abstract An 83-year-old man presented with worsening of respiratory discomfort and underwent close examination which revealed a large mediastinal lipoma measuring 15 X 10 cm. The patient showed heart failure symptoms due to heart compression by tumor. The tumor was completely removed safely and reliably by cutting the ascending aorta main pulmonary artery and superior vena cava. Although preoperative examination could not determine whether the tumor was lipoma or liposarcoma we selected an invasive surgical therapy because neither radiation therapy nor chemotherapy was considered effective for either type of tumor. We report here a very rare case of heart-compressing mediastinal tumor. Introduction Mediastinal lipoma is a rare tumor of the mediastinum and causes few clinical symptoms 1 . Even if diagnosed pathologically as benign mediastinal lipoma causing clinical symptoms is considered clinically malignant. We achieved complete removal of a 15 X 10 cm large mediastinal lipoma by cutting the ascending aorta main pulmonary artery and superior vena cava in a patient who developed heart failure due to heart compression by the tumor. Tumor removal using this approach is rare and is therefore reported here. Case report An 83-year-old man showed sinus rhythm on echocardiography but occasionally showed paroxysmal atrial fibrillation suspected to be due to left atrial compression. With respiratory discomfort worsened to NYHA III the patient underwent close examination by computed tomography and was found to have a large tumor 15 X 10 cm behind the ascending aorta and pulmonary artery and compressing the right and left atria Fig 1 . The tumor was .