Shuichiro Sugimura

Primary Cardiac Sarcoma

Two case reports of primary cardiac sarcoma, which is uncommon, are presented. The first case, a 38-year-old male, complained of chest tightness. Chest roentgenograms showed enlargement of the cardiac shadow and left pleural effusion. Transthoracic echocardiography and chest magnetic resonance imaging showed a tumor in the right atrium, and pericardial effusion. The tumor involved the right atrial wall and interatrial septum, and was partially resected. Pathohistological examination revealed angiosarcoma. He died 1 month later. The second case, a 19-year-old male complained of dyspnea and orthopnea. Chest roentgenograms showed pulmonary congestion. Transthoracic echocardiography showed a large mobile mass in the left atrium. An emergency operation was performed and the tumor was totally resected. Pathohistological examination demonstrated leiomyosarcoma. The postoperative course was uneventful, but the tumor rapidly recurred. Second and third operations were performed at intervals of 2 months. After the third operation, he was treated with radiotherapy. Local recurrence was not found but multiple distant metastases were found 2 months after completion of radiation therapy.

A Case of Left Completion Pneumonectomy for Recurrent Lung Cancer and Left Main Bronchial Stenosis Due to Postoperative Pulmonary Torsion.

症例は68歳の女性.1990年9月25日原発性肺癌で左上葉切除+R2a郭清を施行した.高分化腺癌で, p-stage I (TIN0M0) であった.術後化学療法 (VP-16, CDDP) を施行した.1991年7月頃より呼吸困難・喘鳴が出現した.胸部CTと気管支鏡検査で左上葉切断部の中枢側の左主気管支の狭窄を認めたが, 再発は認めなかった.経過観察中狭窄による症状が進行した.1994年2月22日の胸部単純X線写真で残存下葉に腫瘤陰影を認め, CT下針生検で再発性肺癌が疑われた.他臓器転移は認めなかった.左主気管支狭窄を考慮し, 4月26日左残存肺全摘術を施行した.左主気管支は上方に偏位し, 時計方向に約90度捻転し, 狭窄は上葉支断端部の中枢側にあり, 内径は3mmであった.再発性肺癌であった.術後呼吸困難は消失し, PSは1であった.左残存肺全摘術後3年7ヵ月で全身転移のため死亡した.