The surgical approach to “dumbbell tumors” of the mediastinum

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Presentation transcript:

The surgical approach to “dumbbell tumors” of the mediastinum M.Behgam Shadmehr, MD, Henning A Gaissert, MD, John C Wain, MD, Ashby C Moncure, MD, Hermes C Grillo, MD, Lawrence F Borges, MD, Douglas J Mathisen, MD The Annals of Thoracic Surgery Volume 76, Issue 5, Pages 1650-1654 (November 2003) DOI: 10.1016/S0003-4975(03)00882-8

Fig 1 Skin incision. The vertical component, which permits laminectomy, is centered at the level of the involved foramen (X) and extends for about 10 cm. It curves forward to join the anterior portion of the thoracotomy incision. The dotted line indicates the thoracotomy beneath the flap. (Reprinted from Ann Thorac Surg, 36, Grillo HC, Ojemann RG, Scannell JG, Zervas NT, Combined approach to “dumbbell” intrathoracic and intraspinal neurogenic tumors, 402–7, 1983, with permission from The Society of Thoracic Surgeons.) The Annals of Thoracic Surgery 2003 76, 1650-1654DOI: (10.1016/S0003-4975(03)00882-8)

Fig 2 Computed tomographic scan of the thorax at the level of T2 following intravenous contrast material demonstrates a soft-tissue mass in the left paravertebral region with direct extension into the left vertebral foramen. There is also slight erosion of the lateral aspect of the vertebral body. The Annals of Thoracic Surgery 2003 76, 1650-1654DOI: (10.1016/S0003-4975(03)00882-8)

Fig 3 Magnetic resonance images of the thoracic spine of the same patient following gadopentetate dimeglumine enhancement with T1 images in the axial (A) and coronal (B) planes demonstrate a heterogeneous soft-tissue mass in the paravertebral region at the level of T2. The mass extends into the vertebral foramina abutting the thecal sac and encompassing the T2 nerve root. The Annals of Thoracic Surgery 2003 76, 1650-1654DOI: (10.1016/S0003-4975(03)00882-8)