右乳癌治療後・肺部分切除後の右房腫瘍に対する低侵襲心臓腫瘍切除術の1例

Minimally Invasive Cardiac Surgery for a Heart Tumor after Breast Cancer Therapy and Partial Lung Resection for Lung Cancer；Report of a Case

はじめに　原発性心臓腫瘍は塞栓症を起こしうるため，摘出手術が必要となる．術式としては，胸骨正中切開による腫瘍の外科的切除術が一般に行われている．しかし，近年は高齢化および合併症などから胸骨正中切開を回避すべき症例がある．われわれは，乳房全摘除術および左肺上葉切除術後の患者に，右第4肋間開胸で右房腫瘍切除術を行ったので，報告する．

Papillary fibroelastoma is a benign tumor of the heart, constituting less than 10％ of heart tumors. When papillary fibroelastoma is diagnosed, surgical treatment must be considered because it may cause embolization such as myocardial infarction and strokes. We experienced a patient with papillary fibroelastoma of the tricuspid valve after total resection of the right breast for breast cancer and partial lung resection for lung cancer. Minimally invasive cardiac surgery （MICS） with right thoracotomy was perfomed to resect the tumor. Though median sternotomy is still the most widely used approach for cardiac tumor, MICS is a useful method for preventing sternal wound infection and promoting wound healing, particularly in a patient with high risk of wound infection like this case.