胸膜巨大孤立性線維性腫瘍術後の再膨張性肺水腫・心房細動

Reexpansion Pulmonary Edema and Atrial Fibrillation after Resection of a Giant Solitary Fibrous Tumor of the Pleura

胸膜の孤立性線維性腫瘍（SFT）は胸膜腫瘍の約4％にみられる比較的めずらしい腫瘍で，多くは臓側胸膜に発生する．無症状で経過し，巨大な状態で偶然発見されることが少なくない．その80％以上は良性であり，完全切除の予後は良好とされている1）．われわれは，胸膜巨大SFTの切除後急性期に再膨張性肺水腫と心房細動を呈した症例を経験したので報告する．

We report a case of giant solitary fibrous tumor （SFT） of the pleura postoperatively complicated with probable reexpansion pulmonary edema and atrial fibrillation. An 85-year-old woman was diagnosed to have a 13 cm sized intrathoracic neoplasm. Upon thoracotomy, the tumor was found to pedunculate from the right lung with no direct invasion to the surrounding structures. Complete resection of the tumor and expansion of the right lung was obtained. Histopathology revealed the tumor was a benign SFT arising from the visceral pleura. An infiltrative shadow in the right lower lung field soon after the surgery suggested a reexpansion pulmonary edema, which eventually recovered within a week. The patient suffered from a refractory atrial fibrillation that led to a congestive heart failure requiring an intensive medical treatment. It is emphasized that thoracic surgeons should be aware of these postoperative complications in treating such a case like this.