Thoracoscopic Wedge Resection for Low-Grade Fibromyxoid Sarcoma (Evans Tumor) with Massive Calcification and Originating from the Lung: A Rare Case in an Unexpected Location.

Hiroki Watanabe, Keita Nakanishi, Harushi Ueno, Taketo Kato, Yoshie Shimoyama, Toyofumi Fengshi Chen-Yoshikawa
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Abstract

We encountered a rare case of low-grade fibromyxoid sarcoma, which is generally known as Evans tumor, with massive calcification originating from the lung. The patient was a 22-year-old man with Duchenne muscular dystrophy who was referred for a detailed investigation of an intrathoracic tumor with massive calcification. Although our preoperative diagnosis was a solitary fibrous tumor originating from the mediastinum or diaphragm, intraoperative thoracoscopy revealed the tumor arising from the left lower lobe without adhesion to the other organs. Considering his medical history, we aimed to preserve lung function and chose wedge resection, which completely removed the tumor. Based on the pathological findings, the tumor was diagnosed as low-grade fibromyxoid sarcoma with massive calcification originating from the lung. Although extremely rare, this tumor should be considered as a differential diagnosis for a solitary lung mass with massive calcification in young adults.

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胸腔镜楔形切除术治疗伴有大量钙化且起源于肺部的低级别纤维肉瘤(埃文斯瘤):意外位置的罕见病例。
我们遇到了一例罕见的低级别纤维肉瘤(一般称为埃文斯瘤),其大量钙化源自肺部。患者是一名患有杜氏肌营养不良症的 22 岁男性,因胸腔内肿瘤伴大量钙化而转诊接受详细检查。虽然我们的术前诊断是来源于纵隔或膈肌的单发纤维性肿瘤,但术中胸腔镜检查发现肿瘤来自左下叶,与其他器官无粘连。考虑到他的病史,我们以保留肺功能为目标,选择了楔形切除术,完全切除了肿瘤。根据病理结果,该肿瘤被诊断为低级别纤维瘤样肉瘤,伴大量钙化,源于肺部。这种肿瘤虽然极为罕见,但应作为青壮年单发肺肿块伴大量钙化的鉴别诊断。
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