The cervical-thoracic approach for the resection of a giant cervico-mediastinal neurogenic tumor: a case report

Many approaches for mediastinal tumor resection have been reported. Superior mediastinal tumors that involve the thoracic inlet and adjacent structures pose problems to thoracic surgeons. The cervicothoracic junction is difficult to access because of the crowded anatomy of this region. No single approach provides the best access to all of the tumors in this region. We introduce the cervical-thoracic approach for complete resection of huge cervicomediastinal neurogenic tumors. With cutting off of the right clavicular, and first, second, and third anterior ribs, both the thoracic and cervical components of the tumor were well exposed. The clavicular and anterior ribs were cut off at the middle segment, avoiding injury to the sternoclavicular joint and muscle attachments. The right clavicular and third ribs were repaired with plates and screws to reconstruct the chest wall. The use of plates and screws expanded our incision options, and we could pay more attention to the protection of body function while excising the tumor.