骨膜外パラフィン充填術後25年目に充填腔拡大を来した1例

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  • Expanding plombage space after extraperiosteal paraffin plombage 25 years earlier. A case report.

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A case of late complication after extraperiosteal paraffin plombage is reported. The patient was a 53-year-old male, right upper lobectomy was performed 26 years previously for pulmonary tuberculosis. Postoperative empyema with bronchopleural fistula was noted. After open drainage thoracotomy, he received extraperiosteal paraffin plombage. He complained a sense of tightness in the right portion of the chest, and subcutaneous soft tumor in the right infrascapular region was observed 4 months before admission. The chest roentgenogram and CT scan revealed an expanded plombage space. CT scan and MRI revealed multiple soft tumors in the expanded plombage space. Plombaged paraffin was removed and the soft tumors were resected. The space was closed by transposition of pedicle muscle flaps obtained from the right latissimus dorsi and serratus anterior. His postoperative course was uneventful and he was discharged on the thirty-fourth day after the operation. Pathologically, vessels with dilated lumen, bleeding and degenerated tissue were noted in the soft mass. In patients who had received extraperiosteal paraffin plombage, long-term postoperative follow up should be made.

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