Chest Wall Rhabdomyosarcoma: A Case Report

胸壁橫紋肌瘤：一病例報告

張光照(Kuang-Chao Chang) ； 彭明仁(Ming-Jen Peng) ； 陳培然(Pei-Jan Chen) ； 劉洪彰(Hung-Chang Liu) ； 曾歧元(Chi-Yuan Tzan)

《胸腔醫學》 17卷4期 (2002/12) Pp. 402-407

摘要

胸壁腫瘤常常以緩慢增大的腫塊表現，造成胸部局部疼痛。將近有六成的胸壁腫瘤是惡性的。橫紋肌瘤是罕見且高度惡性的腫瘤，經常對放射治療產生耐受性，外科切除合併化學治療可以產生最佳的效果。
我們報告一位56歲的男性，主訴有20天的漸歇性胸痛，疼痛會伴隨著身體的運動而加劇。理學檢查發現，在右前胸第六及第七肋間，有輪廓不清的突出腫塊。血液學檢查及肺功能都在正常範圍。X光顯示右下胸壁有橢圓形鈣化。藉由超音波導引的經皮穿刺抽取細胞檢查，高度懷疑是惡性間皮瘤。在進行外科切除胸壁病灶及肺部楔形切除後，病理切片及特殊染色報告顯示，此腫瘤為橫紋肌瘤。

關鍵字

胸壁腫瘤 ； 橫紋肌瘤 ； 胸痛

並列摘要

Chest wall tumors usually present as a slowly enlarging mass causing localized dull pain. Approximately 60% are malignant. Rhabdomyosarcomas are rare and highly malignant tumors sometimes found on the chest wall. They are relatively radioresistant; surgical resection should be combined with adjuvant chemotherapy to achieve the best survival.
We report a 56-year-old patient presenting with intermittent chest pain related to movement lasting for 20 days. The physical examination revealed an ill-defined protruding soft tissue mass located on the right anterior chest wall between the 6th and 7th intercostal space. Chest X-ray showed an oval-shaped calcification in the lower right chest wall.
Echo-guided needle aspiration was performed. The cytologic examination was highly suggestive of a malignant mesothelioma, and the pathologic examination revealed vimentin-positive sarcoma. After the surgical removal of the chest wall lesion, and a wedge resection of the lung, the final pathologic diagnosis was rhabdomyosarcoma.
Chest wall sarcomas, therefore, should be considered in those who suffer from intermittent chest pain, although they are uncommon.

並列關鍵字

chest wall tumor ； rhabdomyosarcoma ； chest pain