Neurogenic tumour of the posterior mediastinum: double the complications

Abstract Background Neuroblastoma is the most common malignant extracranial solid tumor in pediatrics patients. Intraoperative hyperthermia is extremely rare in patients with neuroblastoma and can cause a series of complications. Here, we represent a case of neuroblastoma accompanied by hyperthermia during anesthesia, and propose a rational explanation and management options. Case presentation The patient had gait disturbance and sitting-related pain without fever. Magnetic resonance imaging revealed a soft tissue mass located in the right posterior mediastinum, paravertebral space and canalis vertebralis. Serum tumor marker screening showed that the patient had increased epinephrine, norepinephrine and neuron specific enolase levels, with an increased 24 hour urine vanillylmandelic acid level. Intraspinal tumor resection was conducted. The temperature of the patient rapidly arose to 40.1 °C over 10 minutes when waiting for tracheal extubation. The arterial gas analysis results indicated malignant hyperthermia was less likely, and dantrolene was not administered. Physical cooling methods were used, and the temperature dropped to 38.6 ℃. The trachea was successfully extubated. Histological results confirmed the diagnosis of neuroblastoma. Conclusions Hyperthermia during anesthesia is a serious adverse event. Catecholamines secreted from neuroblatoma cells can lead to hypermetabolism and hyperthermia. Surgeons and anesthesiologists should be aware of the possibility of hyperthermia in patients with neuroblastoma.

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Mediastinal anatomical landmarks, their variants and tips for video-assisted thoracoscopic navigation during oesophageal extirpation

Surgical and Radiologic Anatomy ◽

10.1007/s00276-021-02820-8 ◽

2021 ◽

Author(s):

Sergey Dydykin ◽

Friedrich Paulsen ◽

Tatyana Khorobykh ◽

Natalya Mishchenko ◽

Marina Kapitonova ◽

...

Keyword(s):

Prone Position ◽

Anatomical Study ◽

Structural Features ◽

Posterior Mediastinum ◽

Visual Navigation ◽

Anatomical Landmarks ◽

Video Assisted ◽

Before And After ◽

Human Cadavers ◽

The Right

Abstract Purpose There is no systematic description of primary anatomical landmarks that allow a surgeon to reliably and safely navigate the superior and posterior mediastinum’s fat tissue spaces near large vessels and nerves during video-assisted endothoracoscopic interventions in the prone position of a patient. Our aim was to develop an algorithm of sequential visual navigation during thoracoscopic extirpation of the esophagus and determine the most permanent topographic and anatomical landmarks allowing safe thoracoscopic dissection of the esophagus in the prone position. Methods The anatomical study of the mediastinal structural features was carried out on 30 human cadavers before and after opening the right pleural cavity. Results For thoracoscopic extirpation of the esophagus in the prone position, anatomical landmarks are defined, their variants are assessed, and an algorithm for their selection is developed, allowing their direct visualization before and after opening the mediastinal pleura. Conclusion The proposed algorithm for topographic and anatomical navigation based on the key anatomical landmarks in the posterior mediastinum provides safe performance of the video-assisted thoracoscopic extirpation of the esophagus in the prone position.

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Pediatric paraganglioma of the posterior mediastinum

Medicine ◽

10.1097/md.0000000000011212 ◽

2018 ◽

Vol 97 (27) ◽

pp. e11212

Author(s):

Miao Yuan ◽

Chang Xu ◽

Gang Yang ◽

Weiya Wang

Keyword(s):

Posterior Mediastinum

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Natural Orifice Translumenal Endoscopic Surgery for Anterior Spinal Procedures

Minimally Invasive Surgery ◽

10.1155/2012/365814 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Priscilla Magno ◽

Mouen A. Khashab ◽

Manuel Mas ◽

Samuel A. Giday ◽

Jonathan M. Buscaglia ◽

...

Keyword(s):

Thoracic Spine ◽

Endoscopic Surgery ◽

Vertebral Column ◽

Bone Biopsy ◽

Posterior Mediastinum ◽

Direct Access ◽

Thoracic Vertebrae ◽

Natural Orifice ◽

Vertebral Bone ◽

Vertebral Bodies

Background. NOTES techniques allow transesophageal access to the mediastinum. The aim of this study was to assess the feasibility of transesophageal biopsy of thoracic vertebrae.Methods. Nonsurvival experiments on four 50-kg porcine animals were performed. Transesophageal access to the mediastinum was attained using submucosal tunneling technique.Results. The posterior mediastinum was successfully accessed and navigated in all animals. Vertebral bodies and intervertebral spaces were easily approached while avoiding damage to adjacent vessels. Bone biopsy was successfully performed without complications, but the hardness of bone tissue resulted in small and fragmented samples.Conclusions. Peroral transesophageal access into the posterior mediastinum and thoracic vertebral bone biopsy was feasible and safe. The proximity of the esophagus to the vertebral column provides close and direct access to the thoracic spine and opens up new ground for the performance of multilevel anterior spine procedures using NOTES techniques.

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A giant posterior mediastinal malignant peripheral nerve sheath tumor and benign neurofibroma in body surface: a case report

BMC Surgery ◽

10.1186/s12893-021-01122-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yan Zhang ◽

Hongfei Cai ◽

Guangchao Lv ◽

Yang Li

Keyword(s):

Peripheral Nerve ◽

Neurofibromatosis Type ◽

Posterior Mediastinum ◽

Pathological Examination ◽

Nerve Sheath Tumor ◽

Tumor Type ◽

Peripheral Nerve Sheath Tumor ◽

Nerve Tumor ◽

Nerve Sheath ◽

Posterior Mediastinal

Abstract Background Neurofibromatosis comprises neurofibromatosis type 1 (NF1) and type 2 (NF2). Major tumor type of NF1 are neurofibroma recognized as benign peripheral nerve tumor, malignant peripheral nerve sheath tumor (MPNST), and glioma. Case presentation We report a woman with a special condition, whose tumors in body surfaces were benign neurofibroma and tumors in posterior mediastinum are MPNST. The chest-enhanced CT suggested a round soft tissue density in posteriormediastium. The diagnosis was established by pathology and immunohistochemistry. A single-stage thoracoscopic mediastinal mass resection was performed. The whole operation went smoothly and the CT scan of lungs did not show relapse of tumor three months later. Conclusions The appearance of neurofibroma should draw particular attention to the possibility of developing MPNST. More careful imaging examinations should be carried out, and pathological examination could diagnose it.

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