背景:原发性肺脑膜瘤(PPM)是一种非常罕见的起源于肺内脑膜的肿瘤。尽管与中枢神经系统(CNS)相似,PPM由于其不经常发生而提出了独特的诊断挑战和治疗考虑。
方法:本病例报告描述了一名73岁的男性,他接受了胸部计算机断层扫描(CT)检查,显示右下叶后基底段有肿块,提示约30-40毫米大小的低度恶性肿瘤。单孔电视胸腔镜手术(VATS)通过局部病灶切除(肺楔形切除术)切除肿块。术中冰冻切片病理提示低度恶性上皮性肿瘤,导致最大肺功能保留的决定,考虑到病人的高龄。手术团队选择了局部切除以确保阴性切缘。组织病理学分析证实了上皮样PPM的诊断,甚至在PPM病例中也是一种罕见的亚型(世界卫生组织[WHO]I级)。患者术后9天出院,无并发症发生,术后1个月恢复正常日常活动。PPM的稀有性排除了标准化的治疗方案,以手术切除为主要方法。然而,由于证据有限,辅助治疗的疗效仍不确定.
结论:本病例报告有助于更好地理解PPM,并强调对这种罕见实体进行全面诊断评估和个体化治疗计划的重要性。
BACKGROUND: Primary pulmonary meningioma (PPM) is an exceedingly rare neoplasm originating in the meninges within the lung. Despite sharing similarities with its central nervous system (CNS) counterparts, PPM presents unique diagnostic challenges and therapeutic considerations owing to its infrequent occurrence.
METHODS: This case report describes a 73-year-old male who underwent chest computed tomography (CT), which revealed a mass in the posterior basal segment of the right lower lobe, suggestive of a low-grade malignant tumor approximately 30-40 mm in size. Single-port video-assisted thoracoscopic surgery (VATS) was performed to resect the mass via localized lesion excision (lung wedge resection). Intraoperative frozen section pathology indicated a low-grade malignant epithelial tumor, leading to a decision for maximal lung function preservation, considering the patient\'s advanced age. The surgical team opted for a localized excision to ensure negative margins. Histopathological analysis confirmed the diagnosis of epithelioid PPM, a rare subtype even among PPM cases (World Health Organization [WHO] Grade I). The patient was discharged 9 days after surgery without complications and resumed normal daily activities 1 month postoperatively. The rarity of PPM precludes a standardized treatment protocol, with surgical resection as the primary approach. However, the efficacy of adjunctive therapies remains uncertain due to limited evidence.
CONCLUSIONS: This case report contributes to a better understanding of PPM and emphasizes the importance of a comprehensive diagnostic evaluation and individualized treatment planning for this rare entity.