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Ganglioneuroma Of The Right Cervicothoracic Transition
Filipe Leite1, Gonçalo Paupério1
1Departamento de Cirurgia Torácica, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal.
Summary
A rare ganglioneuroma in a young man was surgically removed from the right pulmonary apex. The tumor encasing major blood vessels required careful dissection and ligation of the thyrocervical trunk.
Area of Science:
- Thoracic surgery
- Surgical oncology
- Vascular surgery
Background:
- Ganglioneuromas are rare, benign tumors typically found in the sympathetic nervous system.
- Pulmonary apex tumors can present diagnostic and surgical challenges due to their location.
- Encasement of vital vascular structures by thoracic tumors necessitates complex surgical strategies.
Observation:
- A 26-year-old male presented with a ganglioneuroma at the right pulmonary apex.
- The tumor infiltrated the mediastinum, extending around the innominate artery and subclavian artery.
- Significant adherence and encirclement of the subclavian artery (>180 degrees) were noted.
Findings:
- Complete resection of the ganglioneuroma was achieved using a right Grunenwald approach.
- The right thyrocervical arterial trunk was ligated during the procedure.
- The tumor's extensive vascular involvement presented a significant surgical hurdle.
Implications:
- Successful resection of large, vascularly-infiltrating pulmonary apex ganglioneuromas is feasible.
- This case highlights the importance of meticulous surgical planning for complex thoracic tumors.
- Understanding the anatomical relationships is crucial for managing mediastinal masses involving major vessels.
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