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18. Jahrestagung der Deutschen Gesellschaft für Thoraxchirurgie

Deutsche Gesellschaft für Thoraxchirurgie

08.10. bis 10.10.2009, Augsburg

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Extensive metastasectomy for a single lesion with cardiac invasion

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  • Do-Hyung Kim - Eulji University Hospital, Thoracic surgery, Daejeon, South Korea
  • Issam Ismael - Medizinische Hochschule Hannover, Thoracic surgery, Daejeon, South Korea
  • Patrick Zardo - Programm für Thoraxchirurgie und Lungenunterstützung der MHH, Thoracic surgery, Daejeon, South Korea
  • Axel Haverich - Medizinische Hochschule Hannover, Thoracic surgery, Daejeon, South Korea
  • Stefan Fischer - Programm für Thoraxchirurgie und Lungenunterstützung der MHH, Thoracic surgery, Daejeon, South Korea

Deutsche Gesellschaft für Thoraxchirurgie. 18. Jahrestagung der Deutschen Gesellschaft für Thoraxchirurgie. Augsburg, 08.-10.10.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocHS7.1

doi: 10.3205/09dgt40, urn:nbn:de:0183-09dgt407

Published: November 20, 2009

© 2009 Kim et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Purpose: Even though metastasectomy is widely accepted as treatment of choice for single metastatic lesions, aggressive surgical approach to tumors with cardiac invasion remains controversial due to high morbidity and mortality.

We report the successful resection of a single metastasis from laryngeal carcinoma invading the right ventricle.

Patient and methods: A 59 years old male patient was admitted to our hospital with an anterior mediastinal mass in February 2009. He underwent laryngectomy and bilateral neck dissection with adjuvant chemotherapy (cisplatin/gemcitabin) and irradiation 2 years prior to admission. Complete staging revealed a single anterior mediastinal mass on CT scan.

Results: We performed a modified anterior thoracotomy with partial lower sternotomy and excised the mass invading the right ventricle with cardiopulmonary bypass support. Repair was achieved through a pericardial patch implemented through reinforced single tie sutures. The patient was transferred from the ICU on POD 3 and discharged on POD 7. The postoperative course was uneventful. Pathologic findings confirmed metastatic squamous cell carcinoma of laryngeal cancer with negative resection margins.

Conclusions: Extensive metastasectomy for single lesions with cardial invasion is feasible with acceptable morbidity in selected patients.