Video thoracoscopic resection of neurogenic tumor in a superior-posterior mediastinum: three case reports.

Neurogenic tumors of the thorax can originate in any neurogenic structure within the chest. Surgical resection is considered the primary treatment of such tumors and usually is performed through a thoracotomy. Recently, using a new approach, we applied the technique of video thoracoscopic surgery to resection a posterior mediastinal tumor. In this paper, we report three patients with superior-posterior mediastinal neurogenic tumors in which the approach to the tumor is technically difficult. Cases 1 and 2 were a 26-year-old man and a 50-year-old asymptomatic man, respectively, and case 3 was a 45-year-old asymptomatic woman. The sizes of the three tumors were 3.0 x 2.5 x 1.8 cm (case 1), 6.0 x 4.0 x 2.0 cm (case 2), and 3.0 x 2.0 x 2.0 cm (case 3). In one case (case 2), minithoracotomy was added to video thoracoscopic surgery for adhesion to the spinal artery and intraspinal extension. A standard thoracotomy was avoided in all three cases. All patients had uncomplicated postoperative courses. Video thoracoscopic resection of a neurogenic tumor in the superior-posterior mediastinum may be a safe and useful approach with improved cosmetic results.