右室を著明に圧排していた悪性孤立性線維性腫瘍

Malignant Solitary Fibrous Tumor Compressing the Right Ventricle

孤立性線維性腫瘍は症状に乏しく，発見時に巨大腫瘍となることが多い．われわれは前縦隔に発生したまれな孤立性線維性腫瘍を経験したので報告する．

An 84-year-old woman was referred to our department with an abnormal mass detected on a chest computed tomography （CT） scan. The CT scan revealed a tumor between the sternum and the right ventricle, fed by the left internal thoracic artery. Multiple hepatic nodules were also observed. An ultrasound-guided biopsy was performed on the liver nodule, which was diagnosed as a solitary fibrous tumor. The tumor was compressing the heart, and the patient was at risk of sudden death, therefore, a decision was made to resect tumor. Preoperative embolization of the left internal thoracic artery was performed to prevent massive intraoperative bleeding. The tumor was resected via a median sternotomy approach. Intraoperatively, feeding vessels entering the tumor from the diaphragm were also identified. Total blood loss was 70 ml. The postoperative course was uneventful.