A CASE OF PERITONEAL MESOTHELIOMA PRESENTED WITH INVASION TO PERICARDIA AND THE LIVER

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  • FUJIMOTO Takaaki
    Department of Surgery, Center for Liver Disease, National Kyushu Medical Center
  • TAKAMI Yuko
    Department of Surgery, Center for Liver Disease, National Kyushu Medical Center
  • WADA Yoshiyuki
    Department of Surgery, Center for Liver Disease, National Kyushu Medical Center
  • SAITSU Hideki
    Department of Surgery, Center for Liver Disease, National Kyushu Medical Center
  • MOMOZAKI Seiya
    Department of Pathology, National Kyusyu Medical Center

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  • 心タンポナーデで発症した横隔膜部腹膜原発中皮腫の１例

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Abstract

A 69-year-old woman visited a neighbor doctor complaining of tightness of the chest and respiratory discomfort. Abdominal ultrasonography and CT scan showed a 10cm-sized liver mass and chest X-ray revealed cardiac tamponade. Pericardial puncture was emergently performed and 800ml bloody effusion (cytology indicated classI) was drained. Then she was referred to our department. MRI and angiography disclosed a blood rich masses in the left lateral segment of the liver, diaphragm and pericardium. Angiosarcoma of the liver was suspected and trans-catheter arterial chemo-embolization (TACE) was performed, followed by lateral segmentectomy of the liver with resecting a part of the left diaphragm and the pericardium. The histopathological diagnosis was malignant mesothelioma. The core of the tumor was located in the diaphragm and the direct invasion up to the pericardium and down to the liver was found. She received 6 cycles of postoperative adjuvant chemotherapy consisting of pemetrexed and cisplatin (CDDP). She has been recurrence-free for more than 16 months.

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