171P - Surgical treatment of mediastinal neurogenic tumors and dumbell syndrome in adults: A 12-year experience, January 2002 to January 2014

Date 17 April 2015
Event ELCC 2015
Session Poster lunch
Topics Lung and other Thoracic Tumours
Surgery and/or Radiotherapy of Cancer
Presenter Fadil Gradica
Citation Annals of Oncology (2015) 26 (suppl_1): 51-54. 10.1093/annonc/mdv053
Authors F. Gradica1, L. Lisha1, D. Argjiri2, F. Kokici3, A. Cami3, G. Cerga4, P. Hyska5, P. Kapisyzi2
  • 1Thorax Surgery Service, University Hospital "Shefqet Ndroqi", ++355AL - Tirane/AL
  • 2Pneumology Service, University Hospital "Shefqet Ndroqi", ++355AL - Tirane/AL
  • 3Anestesie-reanimation Service, University Hospital "Shefqet Ndroqi", ++355AL - Tirane/AL
  • 4Pathology Service, University Hospital "Shefqet Ndroqi", ++355AL - Tirane/AL
  • 5Imagery Service, University Hospital "Shefqet Ndroqi", ++355AL - Tirane/AL

Abstract

Aim/Background

Neurogenic tumors are often observed in the paravertebral sulcus. They are generally benign in adults and are good candidates for resection by thoracotomy approach and posterior approach, hemilaminectomy and costotransverectomy, video-assisted thoracic surgery (VATS). We review our series of thoracic neurogenic tumors, focusing on their surgical management.

Methods

The medical charts of 38 patients with mediastinal neurogenic tumors, treated from January 2002 to January 2014, were reviewed regarding the radiographic presentation, histopathology, and surgical treatment of these tumors.

Results

The patients included 26 men and 12 women (mean age, 46 years; range, 19-65 years). Twenty patients were pathologically diagnosed with schwannomas, seven with neurofibromas, and six with ganglioneuromas. The median tumor size was 8.5 cm (range, 2.8-16 cm). The tumors were located in the paravertebral sulcus in 35 patients, chest wall in two patients, and visceral compartment in one patient. 30 patients (90 %) underwent resection via standard posterior thoracotomy, in five patients with dumbbell tumors and posterior approach, hemmilaminectomy and costotransversectomy, whereas the remaining 3 patients were resected with VATS. There was one patient tumor-related death and recurrence in one patient during follow-up.

Conclusions

As expected, the most frequent mediastinal neurogenic tumor was schwannoma originating from the sympathetic chains. Infrequently, tumors may arise from the vagus nerve in the visceral compartment of the mediastinum or from an intercostal nerve if they are located at sites distant from the mediastinum.

VATS is a good alternative for mediastinal neurogenic tumors smaller than 5 cm or that preoperatively lack features of intraspinal extension.

Disclosure

All authors have declared no conflicts of interest.