2017 Volume 31 Issue 2 Pages 254-259
Tumors that originate in the sympathetic ganglia often extend with a craniocaudal orientation in paravertebral lesions. We report a case of posterior mediastinal ganglioneuroma that extended into the retrocrural space, and discuss the surgical modality to resect a neurogenic tumor located in a thoracoabdominal lesion. A 49-year-old female was referred to us with a mass, measuring 9×8×2 cm, that extended from TH9 to L1 levels in the paravertebral lesion and tapered into the retrocrural space. We made a preoperative diagnosis of a neurogenic tumor and conducted thoracoscopic surgery in the semi-prone position with an artificial pneumothorax to resect the tumor in the lowest position of the thorax. A favorable operating field in the posterior mediastinum facilitated meticulous dissection to resect the tumor with the affected sympathetic nerve and splanchnic nerve, and the involved azygos vein, while conserving the thoracic duct. The final pathology of the tumor revealed a ganglioneuroma, and she was discharged on postoperative day 5.
