Thoracic Neurofibroma in a girl excised thoracoscopically

1. Thoracoscopic Neurofibroma
excision
Prakash Agawral
R.K.Bagdi
Apollo Children’s Hospital

2. History
• A 12 year old girl
• Swelling in the
-Right index finger
-left side neck region
pushing the
sternoclavicular joint
anteriorly and
deforming it.

3. Examination
• Multiple skin nodules all over the body with
melanotic freckles over the skin.
• Diagnosis of Neurofibroma advised CT Scan
thorax, to see for any thoracic extension

4. Radiology
• Lesion in the apical area
of left hemithorax and a
separate mass in the
neck.
• The mass had no spinal
extension and was
causing scoliotic
deformity of the spine.
• It was situated between
the bifurcation of the
arch and subclavian
vessels.

5. Surgery
• We planned a
thoracoscopic removal of
the intrathoracic mass in
the apex of left
hemithorax.
• The patient was placed in
a semi prone position and
-ports were introduced in
the 5th intercostal space at
the tip of scapula,
-posterior axillary line and
-medial border of scapula.

6. Surgery

7. Post op
• Recovered well
• Full feeds after 8 hours
• ICD out on 2nd post op
day
• Discharged after 3 days
• Histopathology -
Neurofibroma

8. Review of literature