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Vol.56 No.4 contents | Japanese/English |
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- Case Report -
Complete Resection of Lung Cancer Invading the Aorta After an Endograft Seal
Rei Kobayashi1, Kana Nagayama1, Yasuhiro Takahashi1, Ryoji Kawano1, Kei Kazuno2, Seiichirou Murata21Department of Thoracic Surgery, 2Department of Cardiovascular Surgery, Itabashi Chuo Medical Center, Japan
Background. According to previous reports, aortic invasion is associated with mortality and morbidity rates of almost 12.5% and 31%, respectively. However, the operative outcomes in cases of aortic invasion with no lymphatic metastasis were preferable. The 5-year survival rate is almost 70%. If the operative risk associated with the resection of cancers with aortic invasion can be improved, then it will be a promising treatment strategy. Case. The patient was a 76-year-old man. An abnormal shadow had been pointed out on his chest X-ray. Computed tomography revealed a mass lesion (3.2×3.0 cm) in the upper lobe of the left lung, along the chest wall and invasion of the aortic arch. Further examinations, including transbronchial lung biopsy and positron emission tomography, revealed that the lesion was squamous cell lung carcinoma. The clinical stage was T4N0M0 stage IIIA. We positioned a thoracic aortic endograft after confirming that the lung cancer had infiltrated the thoracic aorta using a thoracic endoscope. Three weeks after the positioning of the endograft, we successfully performed en bloc tumor resection. The operation included the resection of the aortic wall and the left upper lobe, without cardiopulmonary bypass. The patient remained in hospital for only ten days after surgery; no intraoperative or perioperative complications were observed. A pathologic examination revealed that the lung cancer had infiltrated the aortic wall adventitia; however, en bloc tumor resection (R0) was successfully performed. The operation included the resection of the aortic wall adventitia and media. Conclusion. We described the safe and complete resection of lung cancer infiltrating the aortic arch with a thoracic aortic endograft.
key words: Endograft, Aorta, Invasion, Lung cancer, Resection
Received: March 8, 2016
Accepted: May 17, 2016
JJLC 56 (4): 303-307, 2016
