2018 Volume 32 Issue 5 Pages 654-658
An anterior mediastinal mass was pointed out on computed tomography of a 65-year-old man during follow-up observation for another disease, and he was introduced to our department. Chest CT revealed a solid lesion of 35 mm in the anterior mediastinum, and the boundary with the pericardium was unclear. Thymoma or thymic carcinoma was suspected; thus, surgery was planned according to our policy. We performed total anterior mediastinal tumor removal, thymectomy, pericardial combined resection, and pericardial reconstruction by video-assisted thoracic surgery with a right-sided approach. Pathological examination revealed tumor cells with small- to medium-sized nuclei with the proliferation of large and small nuclei in a solidified alveolar form, fibrotic septal walls, necrotic nests, and scattered calcification. Immunostaining was positive for nervous system markers (synaptophysin and chromogranin A), as well as CD56. Based on these findings, the patient was diagnosed with neuroblastoma. Neuroblastoma is extremely rare in adults, and there are no established treatment guidelines. We herein report on the diagnosis and treatment as well as discuss similar cases that have been reported in the pertinent literature.
