Supraclavicular-median sternotomy approach for a large neurilemmoma invading the thoracic outlet: a case report and review of the literature.
Neurilemmoma
Supraclavicular-median sternotomy
Surgical approach
Thoracic outlet
Journal
Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113
Informations de publication
Date de publication:
04 Oct 2024
04 Oct 2024
Historique:
received:
26
03
2024
accepted:
11
09
2024
medline:
5
10
2024
pubmed:
5
10
2024
entrez:
4
10
2024
Statut:
epublish
Résumé
Large mediastinum tumors invading the thoracic outlet have consistently been a challenge in thoracic surgery. Due to the large size of the tumor and its proximity to many important tissues, appropriate surgical approaches are crucial for a successful surgery. Here, we present a case of a large neurilemmoma that invaded the thoracic outlet that was resected by a supraclavicular-median sternotomy approach. The case was a 58-year-old woman with a large mass in the right chest cavity that had invaded the thoracic outlet. The preoperative biopsy showed a blood clot with a few fibrous connective tissues covered by a single layer of flat epithelium. There was insufficient evidence to diagnose the mass as a tumor, and imaging examinations suggested a diagnosis of solitary pleural fibroma. For good exposure of the cranial and caudal aspects of the large mass, we devised a median sternotomy combined with a supraclavicular approach and safely achieved complete resection. The patient recovered well and experienced no severe complications or functional restrictions of the upper extremity. The postoperative pathology diagnosis was a neurilemmoma. The supraclavicular-median sternotomy approach could be an optional approach for the complete resection of large mediastinal tumors invading the thoracic outlet.
Sections du résumé
BACKGROUND
BACKGROUND
Large mediastinum tumors invading the thoracic outlet have consistently been a challenge in thoracic surgery. Due to the large size of the tumor and its proximity to many important tissues, appropriate surgical approaches are crucial for a successful surgery.
CASE PRESENTATIONS
METHODS
Here, we present a case of a large neurilemmoma that invaded the thoracic outlet that was resected by a supraclavicular-median sternotomy approach. The case was a 58-year-old woman with a large mass in the right chest cavity that had invaded the thoracic outlet. The preoperative biopsy showed a blood clot with a few fibrous connective tissues covered by a single layer of flat epithelium. There was insufficient evidence to diagnose the mass as a tumor, and imaging examinations suggested a diagnosis of solitary pleural fibroma. For good exposure of the cranial and caudal aspects of the large mass, we devised a median sternotomy combined with a supraclavicular approach and safely achieved complete resection. The patient recovered well and experienced no severe complications or functional restrictions of the upper extremity. The postoperative pathology diagnosis was a neurilemmoma.
CONCLUSIONS
CONCLUSIONS
The supraclavicular-median sternotomy approach could be an optional approach for the complete resection of large mediastinal tumors invading the thoracic outlet.
Identifiants
pubmed: 39367392
doi: 10.1186/s13019-024-03050-w
pii: 10.1186/s13019-024-03050-w
doi:
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
589Informations de copyright
© 2024. The Author(s).
Références
Dartevelle PG, Chapelier AR, Macchiarini P, Lenot B, Cerrina J, Ladurie FL, et al. Anterior transcervical-thoracic approach for radical resection of lung tumors invading the thoracic inlet. J Thorac Cardiovasc Surg. 1993;105(6):1025–34.
doi: 10.1016/S0022-5223(19)33774-2
pubmed: 8080467
Dartevelle P, Macchiarini P. Surgical management of superior sulcus tumors. Oncologist. 1999;4(5):398–407.
doi: 10.1634/theoncologist.4-5-398
pubmed: 10551556
Grunenwald D, Spaggiari L. Transmanubrial osteomuscular sparing approach for apical chest tumors. Ann Thorac Surg. 1997;63(2):563–6.
doi: 10.1016/S0003-4975(96)01023-5
pubmed: 9033349
Bandiera A, Negri G, Melloni G, Mandelli C, Gerevini S, Carretta A, et al. Management of intrathoracic benign schwannomas of the brachial plexus. Case Rep Surg. 2014;2014:130492.
pubmed: 25143855
pmcid: 4129927
Sakuraba M, Miyasaka Y, Kodu Y, Suzuki K. The cervical anterior approach for the resection of superior posterior neurogenic tumor: a case report. Ann Thorac Cardiovasc Surg. 2012;18(1):42–4.
doi: 10.5761/atcs.cr.11.01670
pubmed: 21881342
Akashi A, Ohashi S, Yoden Y, Kanno H, Tei K, Sasaoka H, et al. Thoracoscopic surgery combined with a supraclavicular approach for removing superior mediastinal tumor. Surg Endosc. 1997;11(1):74–6.
doi: 10.1007/s004649900299
pubmed: 8994994
Kayawake H, Chen-Yoshikawa TF, Date H. Dual approach for large mediastinal tumors in the thoracic outlet: transmanubrial osteomuscular sparing approach and video-assisted thoracoscopic surgery. J Cardiothorac Surg. 2019;14(1):42.
doi: 10.1186/s13019-019-0863-5
pubmed: 30808387
pmcid: 6390527
Liu Y, Lu T, Fan H, Xu S, Ding J, Lin Z, et al. Surgical approaches to non-thyrogenic and non-thymic Mediastinal tumors of the thoracic Inlet. Thorac Cardiovasc Surg. 2018;66(4):336–43.
doi: 10.1055/s-0036-1586156
pubmed: 27494749
Pan X, Gu C, Wang R, Zhao H, Yang J, Shi J. Transmanubrial osteomuscular sparing approach for resection of cervico-thoracic lesions. J Thorac Dis. 2017;9(9):3062–8.
doi: 10.21037/jtd.2017.08.99
pubmed: 29221280
pmcid: 5708451
Rena O, Filosso PL, Papalia E, et al. Solitary fibrous tumor of the pleura: surgical treatment. Eur J Cardiothorac Sury. 2001;19(2):185.
doi: 10.1016/S1010-7940(00)00636-9
Reeder LB. Neurogenic tumors of the mediastinum. Semin Thorac Cardiovasc Surg. 2000;12(4):261–267. https://doi.org/10.1053/stcs.2000.16738 . PMID: 11154721.
Rodriguez EF, Jones R, Miller D, Rodriguez FJ. Neurogenic tumors of the Mediastinum. Semin Diagn Pathol. 2020;37(4):179–86.
doi: 10.1053/j.semdp.2020.04.004
pubmed: 32448592
Pavlus JD, Carter BW, Tolley MD, Keung ES, Khorashadi L, Lichtenberger JP 3. rd. imaging of thoracic neurogenic tumors. AJR Am J Roentgenol. 2016;207(3):552–61.
Nakazono T, White CS, Yamasaki F, Yamaguchi K, Egashira R, Irie H, et al. MRI findings of mediastinal neurogenic tumors. AJR Am J Roentgenol. 2011;197(4):643–52.
doi: 10.2214/AJR.10.6119
Song SW, Jung JI, Lee KY, et al. Malignant solitary fibrous tumor of the pleura: computed tomography-pathological correlation and comparison with computed tomography of benign solitary fibrous tumor of the pleura[J]. Jpn J Radiol. 2010;28(8):602–8.
doi: 10.1007/s11604-010-0484-3
pubmed: 20972860