Department of Translation Medicine, Thoracic Surgery Unit, Università della Campania "Luigi Vanvitelli", Naples, Italy.
Genomics and Experimental Oncology Unit, IOM Ricerca, Viagrande, Italy.
Thorac Cancer. 2023 Jul;14(19):1824-1830. doi: 10.1111/1759-7714.14927. Epub 2023 May 18.
Intrathoracic neurogenic tumors (INTs) are derived from nerve tissue and grow within the chest. Preoperative diagnosis can be challenging and only complete surgical exeresis enables confirmation of the suspected diagnosis. Here, we analyzed our experience on management of paravertebral lesions with solid and cystic patterns.
A monocentric retrospective study was conducted, which included 25 consecutive cases of ITNs in the period from 2010 to 2022. These cases had been surgically treated by thoracoscopic resection alone, or in combination with neurosurgery in the case of dumbbell tumors. The demographic and operative data along with complications were recorded and analyzed.
Twenty-five patients were diagnosed with a paravertebral lesion of which 19 (76%) had solid features and six (24%) had cystic features. The most common diagnosis was schwannoma (72%), followed by neurofibroma (20%) and malignant schwannoma (8%). In four cases (12%) the tumor showed an intraspinal extension. None of the patients had recurrence until 6 months of follow-up. Comparison between the VATS and thoracotomy procedures showed that outcome of discharge on the postoperative day, on average, was 2.61 ± 0.5 versus 3.51 ± 0.53, respectively (p-value <0.001).
The treatment of choice for INTs is complete resection which is tailored to tumor size, location, and extension. In our study, paravertebral tumors with cystic characteristics were not associated with an intraspinal extension and did not show a different behavior from solid tumors.
胸腔内神经源性肿瘤（INTs）来源于神经组织，生长在胸腔内。术前诊断具有挑战性，只有完整的手术切除才能确认疑似诊断。在此，我们分析了我们在处理具有实性和囊性模式的椎旁病变方面的经验。
进行了一项单中心回顾性研究，纳入了 2010 年至 2022 年间连续 25 例经手术治疗的 INT 患者。这些病例均通过胸腔镜单独切除或在哑铃型肿瘤的情况下与神经外科联合切除。记录和分析了人口统计学和手术数据以及并发症。
25 例患者被诊断为椎旁病变，其中 19 例（76%）具有实性特征，6 例（24%）具有囊性特征。最常见的诊断是神经鞘瘤（72%），其次是神经纤维瘤（20%）和恶性神经鞘瘤（8%）。在 4 例（12%）病例中，肿瘤存在椎管内延伸。在 6 个月的随访中，没有患者出现复发。胸腔镜与开胸手术的结果比较显示，术后平均出院日分别为 2.61±0.5 天和 3.51±0.53 天（p 值<0.001）。
INTs 的治疗选择是完全切除，切除方式根据肿瘤大小、位置和延伸情况而定。在我们的研究中，具有囊性特征的椎旁肿瘤与椎管内延伸无关，且与实性肿瘤的行为没有差异。
