Thoracoscopic surgery combined with a supraclavicular approach for removing a cervico-mediastinal neurogenic tumor: a case report.

The neurogenic tumors in the posterior mediastinum sometimes extend into the vertebral canal, known as dumbbell tumors, but cases in which the neurogenic tumor extends to the cervical region are rare. A 19-year old female with a right-sided posterior mediastinal mass, without either Horner's syndrome or pain on the right upper extremity, was referred to our hospital. The chest computed tomography (CT) revealed a large posterior mediastinal mass, measuring 80x50x50 mm in size, which was suspected to be a neurogenic tumor, and the right vertebral artery (RVA) was involved in the tumor at the Th1 to C7 spinal level. Surgical removal of the tumor using video-assisted thoracoscopic procedures through a limited axillary route combined with a supraclavicular approach by a right semi-collar incision was successfully performed. The RVA had to be sacrificed in order to remove the tumor. She was discharged from the hospital on the 12(th) postoperative day. The combined approach using video-assisted thoracic surgery (VATS), with a limited mini-transverse axillary and supraclavicular incision was useful for the removal of a cervico-mediastinal tumor.