胸部外科

Abstract

A 30-year-old man visited a local hospital with the chief complaints of a cough and tightness of thechest. He was found to have an anterior mediastinal tumor, and was referred to our hospital for treatment.He was diagnosed with a large mediastinal tumor, over 15 cm in long diameter, compressing theheart and superior vena cava. The tumor was resected, and diagnosed as a multilocular thymic cyst.He followed an uneventful postoperative course, and was discharged. Later, he re-visited us with severecough and bloody sputum. Despite further evaluation, no definitive diagnosis could be made. Chestcomputed tomography （CT） revealed a mass in the left pulmonary hilum and multiple nodules in theleft lung field. The symptoms rapidly worsened until his death. At autopsy, the left lung lesion wasdiagnosed as hemangiosarcoma. It was also confirmed that the multilocular thymic cyst contained minute germ cell neoplastic（ seminomatous） and hemangiosarcomatous components. We speculate thatthe hemangiosarcomatous component arising in association with the seminoma metastasized to the leftlung.