肺動脈原発血管内膜肉腫に対する外科治療の1例

Surgical Treatment for Primary Pulmonary Artery Sarcoma；Report of a Case

はじめに　原発性肺動脈肉腫はまれな疾患であり，外科的切除を行わない場合の予後は1.5ヵ月ともいわれるきわめて予後不良の疾患である．われわれは，肺動脈原発血管内肉腫に対して外科的切除を行い，良好な結果を得たので報告する．

Primary pulmonary artery sarcoma is a very rare tumor. The prognosis of primary pulmonary artery sarcoma is extremely poor and it is reported as 1.5 months without treatment. Here we report our experience of surgical treatment of primary pulmonary artery sarcoma. A 66-year-old woman with a diagnosis of pulmonary sarcoma by chest computed tomography （CT） scan was referred to our hospital because of a loss of consciousness. An emergecy surgery was planned to eliminate the risk of sudden death. To avoid circulatory collapse, we placed her on extracorporeal bypass before anesthesia induction. The tumor extending from right ventricle outflow tract to bilateral pulmonary artery was removed and resected without leaving residual mass, but the surgical margin was positive, and adjuvant chemoradiotherapy was performed after discharge. In conclusion, surgical resection was succesfully conducted to avoid sudden death.