Neurinoma (Differential diagnosis tumor posterior mediastinum)

metu_17_n.jpg: Operative findings following thoracotomy: Longitudinal-oval mass lying in the posterior mediastinum which runs parallel to the ribs recognizable at the top. An important differential diagnosis of the typical neurogenic mediastinal tumors 'neuroblastoma, ganglioneuroblastoma, and ganglioneuroma' are neurinoma or neurofibroma of the peripheral nerves. It concerns mainly neurinomas which originate from the intercostal nerves close to the costovertebral angle and may reach a considerable size before symptoms and signs become obvious, in contrast to the more peripherally situated tumors. In this 12-year-old girl the inhomogeneous mass runs parallel to a rib in the costovertebral angle and emerges into the posterior mediastinum by more than 5 cm.