Neurogenic mediastinal tumours, a ten-year experience

ABSTRACT

Neurogenic tumours represent 20% of mediastinal tumors in adults and 35% of such tumours in children; as shown in most of previous studies. We reviewed the patients in whom we found surgical mediastinal tumours in our unit from 1[st] May, 1995 through June 2005. The aim is to evaluate management of cases proved to be neurogenic mediastinal tumours. During the last ten years, we admitted into our unit 132 patients with surgical mediastinal tumours. Full investigations including CT-scanning with contrast and CT- guided biopsy or ultrasound guided biopsy were performed. Thirty-three patients were proved to have neurogenic tumours. From these 132 patients with surgically-treatable mediastinal masses, we found 33 cases of neurogenic pathology [25% are neurogenic tumours]. All neurogenic tumours were in the posterior mediastinum, and represent 75% of all posterior mediastinal masses. There were 29 adults and 6 children [aged <16 years] Mean age was 36.4 years ranging from 5 to 67 years. Nineteen patients were females and only 14 were males. At operation, 27 had complete surgical resection while six patients had only biopsy. We did not find any dumbbell tumour among our patients. After pathological examination there were 14 benign schwannomas, 3 neurofibromas 2 ganglioneuromas, 4 malignant schwannomas, 3 neurobalstomas and one ganglioneuroblastoma. All patients with malignant lesions were from North Sinai. In our series, neurogenic tumours represented 25% of all mediastinal tumours, 39.4% in children and 21.3% in adults included in the study [132 patients]. Benign tumours had an excellent prognosis after resection and a five-year-follow up. In our series, malignant ones represented 22% of all neurogenic masses. Prognosis of these malignant tumours in children was better than in adults. The higher the grade of malignancy the poorer is the prognosis even after radio and/or chemotherapy. Neurogenic tumours are more frequent in females. They should be treated early to get a better prognosis. Incidence of tumours is markedly higher among patients from North Sinai. High resolution CT and/or US studies were quite enough for accurate diagnosis. MRI studies were not essential to diagnose any of our cases