10th European Society of Paediatric Endoscopic Surgeons E-Congress, Strasbourg, Fransa, 18 Eylül 2020, ss.22
Total surgical excision of the primary tumor is critical for outcome in the treatment of neuroblastoma. For thoracoabdominal tumors that extend from posterior mediastinum to retroperitoneum, generally wide abdominal or thoracoabdominal incisions are preffered. We aimed to present the first thoracoscopic total excision of a thoracoabdominal neuroblastoma in English literature.
A five-year old boy who was investigated for abdominal pain was refferred due to a lobulated paravertebral 8x3x2cm mass located in the posterior medastinum extending to retroperitoneum (10th thoracal - 3rd lumbar vertebrae). It encased aorta 180 degrees and deplaced inferior vena cava anteriorly without intraspinal extension. The diagnosis was grade IV, high risk, poorly differentiated neuroblastoma with multiple bone and bone marrow metastases. There was minimal response to neoadjuvant chemotherapy. Total excision was achieved via right thoracoscopy. The caudal end of the dissection was confirmed by intraoperative flouroscopy. He was discharged on 4th POD. No residual mass or complications were observed whereas metastases regressed with immunotherapy during the 12 months of follow-up.
Total thoracoscopic excision of thoracoabdominal neurogenic tumors extending to third lumbar vertebrae is possible, safe and efficient in selected patients.