[Thoracoscopic enucleation for sclerosing hemangioma of the lung--a case report]

A 30-year-old female with sclerosing hemangioma of the lung (SHL) was managed by thoracoscopic enucleation. Under the left lateral decubitus position, four small skin incisions were made. The tumor, approximately 2.5 cm in diameter, was just under the pleura at the right S5, and was clearly demarcated without adhesions to mediastinal pleura. Because the tumor located near the hilum, a partial resection by intrathoracic Endo-GIA could not be performed. So the tumor was enucleated bluntly with an electrode knife being tugged by a tractive thread. After it was diagnosed as SHL by intraoperative imprint cytology, the stump was closed with running suture of 3-0 nylon. The patient was discharged on the 10th postoperative day without complication. No recurrence was found during a follow-up period of six months after the operation. Immunohistochemical findings suggested that the tumor cells were derived from type II pneumocytes. Thoracoscopic surgery appears to be a good indication for SHL which commonly occurs in young or middle-aged women and which is difficult to be diagnosed preoperatively. Thoracoscopic enucleation is considered to be a one of the safe methods especially for SHL which can not be resected by Endo-GIA.