胸腔鏡補助下に切除した縦隔内迷入性甲状腺腫の1例

A case of aberrant mediastinal goiter resected by video-assisted thoracic surgery

◆要旨：患者は65歳，女性．検診X線・胸部CTにて胸部異常陰影を指摘され，精査加療目的に受診した．胸部造影CTにて中縦隔気管右前方に31mm大の辺縁整で境界明瞭な腫瘤を認め，内部は不均一で石灰化を伴い，腕頭動脈から栄養され強い造影効果を示した．良性縦隔腫瘤の診断にて胸腔鏡補助下縦隔腫瘤摘出術を施行した．病理検査にて甲状腺腫と診断されたが，腫瘤と頸部甲状腺との連続性を認めず，縦隔内迷入性甲状腺腫と診断した．縦隔内甲状腺腫に対し胸腔鏡補助下の切除が有用であった．

A 65-year-old woman was admitted to our hospital as a result of an abnormal shadow which was observed on her X-ray. Chest CT revealed a right middle mediastinal mass that was measured to be 31mm×21mm in size. The mass exhibited a clear margin and nonhomogeneous density with calcification. Enhanced CT demonstrated no communication between the mass and the thyroid gland. The mass was feeded by the brachiocephalic artery. We diagnosed benign mediastinal tumor and resected by video-assisted thoracic surgery（VATS）. The mass was diagnosed as nodular hyperplasia of the thyroid. VATS was useful procedure for aberrant mediastinal goiter.