Malignant Pleural Mesothelioma with the Presentation of a Lobulated Cyst and Mediastinal Involvement-A Case Report

惡性肋膜間皮瘤以囊狀病灶併縱膈腔侵犯為表現－病例報告

陳育鵬(Yu-Peng Chen) ； 張意恆(Yi-Han Chang) ； 杜興洋(Hsing-Yang Tu) ； 陳寬榮(Kuan-Jung Chen)

《胸腔醫學》 19卷5期 (2004/10) Pp. 382-387

https://doi.org/10.29806/TM.200410.0011

摘要

原發惡性肋膜間皮瘤在肋膜腫瘤中較為罕見，但近年來有逐漸增加之趨勢，而其快速復發、極易侵犯以及對治療反應不良的特性也使得此疾病預後不佳。
我們報告一位58歲男性，主訴近二個月來有逐漸加重之呼吸不順及胸痛，理學檢查發現右側呼吸音減少，實驗室檢驗無特殊異常；而胸部影像攝影發現在右側有肋膜積水併有數個囊狀病灶與縱膈腫瘤之情形，經外科清創並採取組織送檢，確定為一惡性肋膜間皮瘤；而病人過去並未有接觸石棉之情形，而家中也未有其他成員有此疾病。病人於是接受化學治療至今約六個月，胸部X光與電腦斷層檢查顯示病灶無繼續擴大之情形，病人目前仍於腫瘤科追蹤治療。

關鍵字

惡性肋膜間皮瘤 ； 囊狀病變 ； 縱膈腔腫瘤

並列摘要

Malignant mesothelioma is a relatively rare tumor; two-thirds of all patient can be traced to having had asbestos contact. The prognosis of malignant mesothelioma remains poor, due to the high recurrence rate, invasion predisposition, and resistance to therapies. Herein, we report the case of a 58-year-old man presenting with progressive dyspnea and chest pain for 2 months. The chest X-ray revealed: 1) a mediastinal mass with a tracheal deviation to the left, and 2) right massive pleural effusion with one loculated component at the right upper lung. Malignant pleural mesothelioma was diagnosed using thoracoscopy with a biopsy. No history of asbestos exposure was found. He has undergone 5 chemotherapy treatments with novelbine and cisplatin in six months(from Aug., 2003 to Feb., 2004). The lesion has remained stationary throughout the course. A review of the literatures has revealed that malignant mesothelioma with a cystic component that invades the mediastinum is rarely reported.

並列關鍵字

malignant pleural mesothelioma ； cystic component ； mediastinal mass