意識消失を呈した巨大成熟型囊胞性奇形腫

Giant Mature Cystic Teratoma Causing Loss of Consciousness before Surgery

巨大化した前縦隔成熟型囊胞性奇形腫による心・大血管の圧迫から意識消失をきたした症例に対し，麻酔導入に細心の注意を払って安全に切除手術を実施しえた症例を経験したので報告する．

A 30-year-old woman who presented loss of consciousness was diagnosed as having large anterior mediastinal tumor. Computed tomography （CT） showed a 17.0×13.0×7.3 cm cystic mass with internal calcification in the anterior mediastinum that was markedly compressing the heart, great vessels, trachea and bronchi. A mature cystic teratoma was suspected, and the mediastinal tumor was resected through a median sternotomy. At the induction of anesthesia to prevent the development of the respiratory and circulatory collapse, the patient was consciously intubated under the right lateral decubitus position while preparing for percutaneous cardiopulmonary support by cardiac surgeons, and the surgery was safely performed. The tumor was pathologically diagnosed as a mature cystic teratoma, and symptoms such as loss of consciousness have disappeared.