Giant neurogenic tumors of mediastinum: report of two cases and literature review

Abstract

Neurogenic tumors are commonly found in the mediastinum, especially in the posterior mediastinum or in the chest wall, neurogenic tumors may reach large size before becoming symptomatic. If the neurogenic tumor occupied more than half size of the chest wall accompanied by mediastinal shift, tracheal compression, or superior vena reflux disorder, it may be called giant intrathoracic neurogenic tumors. Giant intrathoracic neurogenic tumors are relatively rare. Most of intrathoracic neurogenic tumors were benign or low-grade malignant tumors in nature. Complete surgical excision should be the rule for these patients. We report two cases of giant neurogenic tumors, and study the clinical manifestations, diagnostic methods, surgical management, and prognosis in the light of the most important published data.

Keywords: Mediastinal neoplasms; giant intrathoracic neurogenic tumors.

Figure 1

CT reveals a huge high-density mass with destruction of the bone and huge lesions located in the lower right side of the chest, adjacent to diaphragm

Figure 2

MRI shows low intensity on T1-weighted image, high intensity on T2-weighted image, and not remarkably strong intensity on the diffusion weighted imaging

Figure 3

Operative view. A huge mass was in the right chest, and densely adhered to the costovertebral region, extending from T5 to T12

Figure 4

Operative specimen

Figure 5

Histopathology shows spindle cell neoplasm, with extensive necrosis, moderate mitotic index and severe atypia, probably a malignant peripheral nerve sheath tumor