後縦隔囊胞摘出術と心臓外科手術を同時に施行した1例

Posterior Mediastinal Cyst Resection during Cardiac Surgery through Median Sternotomy：Report of a Case

はじめに　偶発的に診断された後縦隔囊胞，心臓弁膜症に対して手術加療を施行したので報告する．

A 47-year-old man presented with hematuria. Computed tomography （CT） showed a posterior mediastinal cyst. Chest magnetic resonance imaging showed a well defined mass with high intensity on T2-weighted images. Echocardiogram revealed severe aortic regurgitation, moderate mitral regurgitation and no continuity between the cyst and the pericardium. We performed aortic valve replacement, mitral annuloplasty and cyst resection after confirming it was not malignant by intraoperative rapid pathological examination. We performed sufficient and safe cyst resection through full sternotomy under cardiac arrest. Pathological examination revealed that cyst was bronchogenic. Bronchogenic cyst has malignant potential and it is very difficult to resect after presenting symptoms. We need to consider the differential diagnosis, the timing of operation and operative strategy.