[A rare case of mediastinal neuroblastoma with pectus excavatum in a 4-month-old boy--a surgical report].

Screening of neuroblastoma is commonly performed on 6-month-old infants; therefore, its discovery in children younger than that age is extremely rare. However, a 4-month-old boy with pectus excavatum was found to also have mediastinal neuroblastoma after close examination. This 7 kg child had no apparent symptoms, yet revealed an egg-sized shadow along the right atrium in the chest X-ray film, and along the right side of the vertebrae on CT. Due to the increase in the size of the tumor after two months of observation, we suspected malignant neurogenic tumor and performed a thoracotomy. With a right posterolateral thoracotomy we removed the dark-brown, elastic tumor measuring 6 x 4 x 3 cm and located along the right side of the vertebrae from III through VIII ribs. The origin was the thoracic sympathicus and the pathological diagnosis of the tumor was neuroblastoma with rosset formation. After conducting a post-operative chemotherapy (Jame's protocol), no evidence of recurrence was observed at 33 months after surgical treatment. We summarized the previously reported seven surgically treated cases of Stage I mediastinal neuroblastoma at less than 12 months of age. Among the 2500 pectus excavatum surgeries that have been held at our department, non has been found to have mediastinal neuroblastoma.