胸腔鏡補助下で切除した砂時計型胸壁脂肪腫の1例

Video-assisted Thoracic Surgery of an Hourglass Transmural Lipoma；Report of a Case

はじめに　脂肪腫は皮下組織など軟部組織によくみられる良性腫瘍であるが，砂時計型の経胸壁型脂肪腫はまれである．われわれは，胸腔鏡補助下に切除した砂時計型胸壁脂肪腫の1例を経験したので報告する．

Hourglass transmural lipomas are rare. A 79-year-old male was referred to our hospital due to an abnormal shadow incidentally found on a chest X-ray 6 years ago. Chest computed tomography and magnetic resonance imaging revealed a well-defined fatty mass like an hourglass, penetrating the right 4th intercostal muscle. The tumor tended to grow slightly and we considered the possibility of well-differentiated liposarcoma. We performed a complete resection of the tumor with partial resection of the 5th rib with the assist of thoracoscopy. The chest wall was reconstructed using an expanded polytetrafluoroethylene （ePTFE） sheet. The tumor was 55×52×47 mm in size and histologically diagnosed as an intermuscular lipoma. Thoracoscopy was useful to determine the excision line.