Excision of Mediastinal Neurogenic Tumour

Mediastinal neurogenic tumours lie mainly in the paravertebral region at any level in the chest, and are usually incidental radiological findings. They should be removed because they may extend through an intervertebral foramen and compress the spinal cord (Fig. 48.1). Rarely, they may develop into a sarcoma. CT and MRI scanning is valuable in determining whether the tumour has extended into the spinal canal. If so, the operation should be preceded by a laminectomy to remove the intraspinal extension. If intraspinal extension is missed and only discovered at operation, an emergency laminectomy is necessary, because oedema and vascular thrombosis affecting the residual portion of tumour may rapidly cause spinal cord ischaemia.