A case of dumbbell tumor of the superior mediastinum removed by combined thoracoscopic surgery.

We report a case of a neurogenic dumbbell tumor in the superior mediastinum resected completely by the combined application of thoracoscopy and neurosurgery performed by an orthopedic surgeon. A 54-year-old female was admitted because her chest X-ray showed a superior mediastinal mass. Computed tomography and magnetic resonance imaging revealed that the tumor was extradural dumbbell-shaped and compressed the spinal cord through the intervertebral foramen between Th2 and Th3. First, she underwent laminectomy of the vertebrae (Th1similarTh3) and separation of the tumor from the dura mater and the root of the second left intercostal nerve in the right semilateral position. Then in the same position, three thoracic ports were placed and the tumor was resected completely using thoracoscopy in a one-stage operation. The pathological diagnosis was neurilemmoma. There has been no sign of serious neurologic deficits or of recurrence four years after the operation. Thus, the procedure is a minimally invasive approach, which is both safe and useful.