広範な前胸壁切除を行ったデスモイド腫瘍

Desmoid Tumor Treated by Wide Resection of the Anterior Chest Wall

デスモイド腫瘍は間葉系前駆細胞由来と考えられており1），全身のさまざまな部位に発生しうる．頻度は年間100万人あたり2～4例とまれな腫瘍であり2），胸壁原発は全体の20％程度にすぎない3）．われわれは，広範な隣接臓器浸潤を呈した胸壁デスモイド腫瘍を経験したので報告する．

Desmoid tumors are rare mesenchymal proliferative tumors that are highly invasive but lack metastatic potential. We report the case of a 72-year-old man with a desmoid tumor arising from the anterior chest wall which invaded neighboring organs extensively. The patient complained of dyspnea on exertion and appetite loss and was referred to our hospital. Chest computed tomography revealed an anterior chest wall tumor 12 cm in diameter adjacent to the right lung, diaphragm, and sternum. An ultrasound-guided biopsy was conducted, and the tumor was diagnosed as a desmoid tumor. He underwent right-sided anterior chest wall resection with combined resection of the right lung, diaphragm, and sternum body. The chest wall defect was reconstructed using an expanded polytetrafluorethylene mesh （dualmesh）. Although initial active surveillance has recently been recommended for asymptomatic patients with non-progressing desmoid tumors, our patient underwent resection because of his symptoms.