應用經食道心臟超音波於手術摘除腎上腺皮質腺癌合併右心房腫瘤血栓之病例報告

Application of Transesophageal Echocardiography in Removal of Right Atrial Tumor Thrombus of Adrenal Cortical Carcinoma-- A Case Report

腎上腺皮質腺癌併發的心房內腫瘤血栓，手術摘除是非常困難的，也容易因腫瘤血栓的摘除不完全，造成肺栓塞。手術中應用多面向經食道心臟超音波，可協助了解心房內腫瘤血栓的位置與大小，並且能確定腫瘤血栓摘除是否完全。我們報告此一病例，是應用經食道心臟超音波於手術中連續監測，成功且完全的摘除心房內腫瘤血栓。

Surgical removal of adrenal cortical carcinoma complicated by intra-atrial tumor thrombus is very difficult and risky if the removal of thrombus is incomplete, leading possibly to pulmonary embolism. Application of multiplane transesophageal echocardiography during surgical operation may help notifying the size and location of tumor thrombus and also help determinating the completeness of the thrombus removal. We present a case of successful removal of adrenal cortical carcinoma with tumor thrombus extension to the right atrium under comprehensive anesthetic care including continuous intraoperative transesophageal echocardiography monitoring.