A rare case of dysphagia and palpitation caused by the compression exerted by an enormous mediastinal lipoma

Abstract

A 65-year-old woman presented with mild dysphagia, weight loss and intermittent palpitation. Chest radiograph revealed a large opacity in the right lower lung field. Subsequent CT scan showed a large posterior mediastinal lipoma extending from the level of the aortic arch to the thoracoabdominal junction. After thoracoscopic resection, the patient's dysphagia and palpitation were resolved. After a follow-up of 2 years, the patient has had no evidence of recurrence.

The adequacy of single-incisional thoracoscopic surgery as a first-line endoscopic approach for the management of recurrent primary spontaneous pneumothorax: a retrospective study

“…Uni-port, single-port and single-incisional thoracoscopic surgery have all suggested that there are a number of procedures that can be performed using only a single small wound. Currently, from primary spontensous pneumothorax to lung cancer resection, thoracoscopic surgery using single-port approach has been shown to be feasible [2,4-7]. Taking advantage of the various modifications endoscopic techniques, we can now perform nearly all such procedures without the need of either curved instruments or additional port wounds.…”

“…Due to the pliancy of the lung tissues, the wound can be very small [4,5]. Currently, the wound size depends on the overall size of the three instruments, including a 10-mm stapler, a 5-mm endoscope and a 5-mm grasp, as shown in Figure 1B.…”

Treatment of Bilateral Empyema Thoracis Using Unilateral Single-Port Thoracoscopic Approach

“…Such techniques had been proposed in the treatment of lung cancer, mediastinal tumor, pneumothorax and most common disease of the chest. [1][2][3][4][5] With modifications of conventional thoracoscopic techniques, the operative field can be extended to the contralateral side of the pleural space. In the case we presented, peel formation and loculations were mainly located in right side pleural space while the left side effusion was relatively free-floating.…”

“…Single-port approach, when operated with experienced surgeon's hands, is much faster than conventional multiport approach and has low conversion rate as we reported earlier. 2,3,5) When treating malignant pleural effusion, mediastinal metastasis may occur if the mediastinum is opened. Therefore, the adequacy of such procedure in treating malignant effusion is still not clear.…”

Technical aspects of single-port thoracoscopic surgery for lobectomy

“…According to our limited experience, the final size of the port wound in single-port VATS depends on the solid portion of the neoplasm (Figure 8) rather than the overall size. For large but very soft tissues, such as normal lung tissue or a specimen of primary spontaneous pneumothorax, they can be easily and gently retracted out into the endo-bag through a tiny wound [5]. The solid part, however, cannot be altered by pressure, as deformation may lead to confusion on the part of the pathologist upon microscopic examination.…”