難治性心囊液を伴ったCrow・深瀬症候群に対する胸腔鏡下心膜開窓術

Video-assisted Thoracoscopic Pericardial Fenestration for Pericardial Effusion in a Patient with Crow-Fukase Syndrome

Crow・深瀬症候群はまれな疾患であり，心囊液を伴った症例に対して，胸腔鏡下心膜開窓術を行った報告はさらにまれである．われわれは本例に対して胸腔鏡下心膜開窓術を行い，良好な結果を得たので，文献的考察を加えて報告する．

A 65-year-old woman was referred to our department with recurrent pericardial effusion. Her serum vascular endothelial growth factor was high, serum M-protein was positive, and nerve conduction velo-city of extremities was decreased. Therefore, she was diagnosed with Crow-Fukase （polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes：POEMS） syndrome, which is characterized by the presence of plasma cell dyscrasia with them. We performed video-thoracoscopic pericardial fenestration with 4×4 cm window. The postoperative course was uneventful, and the pericardial effusion completely disappeared. Video-assisted thoracoscopic pericardial fenestration was a safe and effective treatment for recurrent pericardial effusion.