Thorac Cardiovasc Surg 2014; 62(02): 147-152
DOI: 10.1055/s-0033-1343898
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Intrathoracic Neurogenic Tumors

Pinar Bicakcioglu
1   Department of Thoracic Surgery, Ataturk Education and Research Hospital for Chest Diseases and Thoracic Surgery, Ankara, Turkey
,
Funda Demirag
2   Department of Pathology, Ataturk Education and Research Hospital for Chest Diseases and Thoracic Surgery, Ankara, Turkey
,
Alkin Yazicioglu
1   Department of Thoracic Surgery, Ataturk Education and Research Hospital for Chest Diseases and Thoracic Surgery, Ankara, Turkey
,
Koray Aydogdu
1   Department of Thoracic Surgery, Ataturk Education and Research Hospital for Chest Diseases and Thoracic Surgery, Ankara, Turkey
,
Sadi Kaya
1   Department of Thoracic Surgery, Ataturk Education and Research Hospital for Chest Diseases and Thoracic Surgery, Ankara, Turkey
,
Nurettin Karaoglanoglu
1   Department of Thoracic Surgery, Ataturk Education and Research Hospital for Chest Diseases and Thoracic Surgery, Ankara, Turkey
› Institutsangaben
Weitere Informationen

Publikationsverlauf

04. Januar 2013

15. März 2013

Publikationsdatum:
23. April 2013 (online)

Abstract

Background Intrathoracic neurogenic tumors are uncommon neoplasms arising from nerve tissues. This study reports on our 24-year single-center experience with intrathoracic neurogenic tumors.

Patients and Methods We retrospectively analyzed the postoperative pathological records of 19,378 operations performed in our clinic between January 1988 and December 2011 and included cases with diagnosis of neurogenic tumors.

Results The study included 149 patients (90 females and 59 males) with an average age of 24.5 years (7 months to 77 years). The study group comprised 29 infants and children, and 120 adults. Of the patients, 72 had benign schwannomas, 10 malignant schwannomas, 17 neurofibromas, 24 ganglioneuromas, 9 ganglioneuroblastomas, 4 neuroblastomas, 9 primitive neuroectodermal tumors, and 4 paragangliomas. Concerning the location of these lesions, 131 were located in the posterior mediastinum, 8 in the lung parenchyma, 5 in the chest wall, 3 in the anterior mediastinum, and 2 in the thoracic inlet. The majority of nerve cell tumors were in infants and children (79.3%), whereas the nerve sheath tumors most commonly occurred in adults (78.3%). There were 117 benign and 32 malignant tumors across all age groups. The rate of malignancy was 41.4% in infants and children, compared with 16.7% in adults. Symptoms were seen in 65% of the adult patients and 79.3% of the infant and children patients. Seven tumors were associated with von Recklinghausen's disease. In six patients (4.0%), the tumor showed an intraspinal extension. Surgical resection of the tumor was complete in 142 of 149 patients (95.3%).

Conclusion The treatment of choice for malignant and benign thoracic neurogenic tumors is complete resection. The objective of resection is to avoid local invasion, facilitate differential histopathological diagnosis to determine other treatment options, and to prevent malignant degeneration.

 
  • References

  • 1 Gangadharan SP. Neurogenic tumors of the posterior mediastinum. In: Sugarbaker DJ, Bueno R, Krasna MJ, Mentzer SJ, Zellos L, , eds. Adult Chest Surgery. 2nd ed. New York, NY: McGraw-Hill; 2009: 1145-1153
  • 2 Takeda S, Miyoshi S, Minami M, Matsuda H. Intrathoracic neurogenic tumors—50 years' experience in a Japanese institution. Eur J Cardiothorac Surg 2004; 26 (4) 807-812
  • 3 Ribet ME, Cardot GR. Neurogenic tumors of the thorax. Ann Thorac Surg 1994; 58 (4) 1091-1095
  • 4 Topçu S, Alper A, Gülhan E, Koçyigit O, Tastepe I, Çetin G. Neurogenic tumours of the mediastinum: a report of 60 cases. Can Respir J 2000; 7 (3) 261-265
  • 5 Oosterwijk WM, Swierenga J. Neurogenic tumours with an intrathoracic localization. Thorax 1968; 23 (4) 374-384
  • 6 Bousamra M, Wrightson W. Neurogenic tumors of the mediastinum. In: Patterson GA, Cooper JD, Deslauriers J, Lerut AEMR, Luketich JD, Rice TW, eds. Pearson's Thoracic & Esophageal Surgery. Vol. 1. 3rd ed. Philadelphia, PN: Churchill Livingstone; 2008: 1634-1640
  • 7 Ohtsuka T, Nomori H, Naruke T, Orikasa H, Yamazaki K, Suemasu K. Intrapulmonary schwannoma. Jpn J Thorac Cardiovasc Surg 2005; 53 (3) 154-156
  • 8 Iwasaki T, Ohta M. okimura A, Kawahara K. Intrapulmonary neurofibroma independent of neurofibromatosis type I. Gen Thorac Cardiovasc Surg 2012; 60: 175-178
  • 9 Reynolds M, Shields TW. Benign and malignant neurogenic tumors of mediastinum in children and adults. In: Shields TW, Locicero J, Reed CE, Feins RH, eds. General Thoracic Surgery. Vol. 2. 7th ed. Philadelphia, PN: Lippincot Williams Wilkins; 2009: 2415-2439
  • 10 Parikh DP, Short M, Eshmawy M, Brown R. Surgical outcome analysis of paediatric thoracic and cervical neuroblastoma. Eur J Cardiothorac Surg 2012; 41 (3) 630-634
  • 11 Ceberut K, Naseri E, Celik A, Muslehiddinoglu A, Ergin I. One-stage combined thoracic ancient schwannomas total removal and coronary artery bypass. Case Rep Med 2011; . doi: 10.1155/2011/497960
  • 12 Domen H, Iwashiro N, Kimura N , et al. Intrapulmonary cellular schwannoma. Ann Thorac Surg 2010; 90 (4) 1352-1355
  • 13 Rosai J. Rosai and Ackerman's Surgical Pathology. 10th ed. Edinburg: Mosby Elsevier; 2011: 468-470
  • 14 Seguin A, Mussot S, Fadel E, Chapelier A, Dartevelle P. Neurogenic intrathoracic tumors. Journée de pathologie thoracique 2004;
  • 15 Yaran P, Tastepe Aİ, Yazıcı Ü, Sak SD. Intrapulmonary solitary fibrous tumour of the lung: a very unusual presentation. Balkan Med J 2011; 28: 466-468
  • 16 Bıçakçıoğlu P, Yazıcıoğlu A, Gökçek A, Karaoğlanoğlu N. Intralobar pulmonary sequestration simulates posterior mediastinal neurogenic tumor. J Clin Anal Med . doi:10.4328/JCAM.1025
  • 17 Reeder LB. Neurogenic tumors of the mediastinum. Semin Thorac Cardiovasc Surg 2000; 12 (4) 261-267
  • 18 Venissac N, Leo F, Hofman P, Paquis P, Mouroux J. Mediastinal neurogenic tumors and video-assisted thoracoscopy: always the right choice?. Surg Laparosc Endosc Percutan Tech 2004; 14 (1) 20-22
  • 19 Liu HP, Yim APC, Wan J , et al. Thoracoscopic removal of intrathoracic neurogenic tumors: a combined Chinese experience. Ann Surg 2000; 232 (2) 187-190