幼児横隔膜原発横紋筋肉腫の1例と本邦報告例の検討

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An 1-year old boy was admitted to our hospital because of difficulty in breathing presenting for 2 weeks. Roentgenologic examination of the chest showed complete opacification of the left hemithorax. Computer tomography scanning showed a large irregular mass at the level of the left diaphragm. An attempted thoraceutesis on the left side gave bloody fluid. Cytological examinatio demonstrated the presence of small malignant tumor cells. Exploratory laparotomy revealed a large hard mass which arised from the left diaphragm and infiltrated into the lesser curvature of the stomach and the lymphnodes. Multiple metastases measuring 5 to 20 mm in diameter were noted all over the omentum. Biopsy of a distant metastatic lesion was done and the specimen was processed to pathological studies with light microscopy and electron microscopy. Final diagnosis was made as embryonal rhabdomyosarcoma. The patient did not well respond to postoperative chemotherapy and radiation therapy. He died in the hospital within a period of 5 months. We were able to collect a total of 40 cases with primary diaphragmatic tumor from the Japanese literature. Among these 40 cases, 23 are benign, whereas 17 are malignant. The cystic type was most frequently seen, namely in 12 cases. Olafsson stated that fibrosarcoma had the highest incidence among malignant tumors, namely in 9 of 33 cases. On the contrary, in the Japanese series, rhabdomyosarcoma was the most frequen type seen, namely in 9 of 17 cases.
日本小児外科学会の論文
1983-06-20

幼児横隔膜原発横紋筋肉腫の1例と本邦報告例の検討

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