A case of mediastinal lesion resected by a transabdominal-transdiaphragmatic approach for recurrent neuroblastoma

Abstract

A 7-year-old boy was diagnosed with neuroblastoma of the right adrenal gland with opsoclonus and myoclonus at 3 years and 6 months of age. He had ganglioneuroblastoma nodular, International Neuroblastoma Risk Group (INRG) clinical stage L2, no MYCN amplification, and was classified as an intermediate risk group. Two years after chemotherapy and operation, recurrence of three longitudinal lymph nodes occurred in the retroperitoneum, and these were resected by laparotomy. The caudal mass located between the abdominal aorta and inferior vena cava was excised. The right lobe of the liver was dislocated, the inferior vena cava to the left side of the caudate lobe of the liver were confirmed, the right diaphragmatic peduncle was longitudinally incised, and two residual tumors were found in the right retrocrural space, which were successfully resected. Postoperative radiation therapy and GD2 antibody infusion were performed, and no residual disease was observed. Therefore, the transabdominal-transdiaphragmatic approach from laparotomy view is effective for posterior mediastinal tumors.