Introduction:Neurogenic chest tumor (NCT) are rare tumors. They usually originate from the nerve sheaths and cells, rarely from the nerve trunks. Adequate treatment is complete surgical resection.In this work, we aimed to study the management peculiarities of NCT.

Methods:

Between 1994 and 2021, 124 patients were managed for a NCT, with curative intent, in the thoracic surgery department of Abderrahmen Mami hospital, Ariana, in Tunisia.

Results:

There were 79 women and 45 men, with a mean age of 41 years. The most common sign was chest pain. The discovery was fortuitous in 23% of cases. Thoracic CT showed a mediastinal mass in 101 cases including 83 tumors in the posterior mediastinum. Foraminal extension was noted in nine cases and widening of the foramina in three others. 45 patients had a chest MRI to confirm the diagnosis of NCT and to specify the endocanal extension noted in 3 cases. The main surgical route was posterolateral thoracotomy(n=72). The procedure was tumor resection in 113 cases and biopsy in 11 others. Histological examination concluded to 101 benign tumors and 23 malignant tumors. The most common benign tumors were schwannomas (n=57) followed by neurofibromas(n=21). The most frequent malignant tumors were malignant peripheral nerve sheath tumors(n=13). A post-operative upper limb motor deficit was observed in 3 cases and a leakage of cerebrospinal fluid in 1 case. After 10 months of follow-up in 67 patients, mortality rate was 4,4% of cases and recurrence occurred in 4% of cases. Chemotherapy was recommended in seven cases.

Conclusion:

NCT are rare slowly growing tumors. The curative treatment is based on a complete surgical resection, the only guarantor of a good prognosis.