Mediastinal sympathetic tumours in children

Eleven children suffering from mediastinal tumours of sympathetic origin (4 neuroblastomas, 2 ganglioneuroblastomas, and 5 ganglioneuromas) are presented. In almost all instances the tumours were discovered by chance following radiological studies of the chest undertaken for various reasons; in 1 case the tumour was unexpectedly discovered during surgery for a retroperitoneal mass. VMA urinary levels were in all cases within the normal range. Surgery was performed as soon as possible. In 5 cases the mass was completely removed, in 5 others incompletely and in 1 case only the extrathoracic portion of the neoplasm was partially removed. In 5 of the 6 malignant cases surgery was followed by complementary radio- and chemotherapy. All the children are in good health 2 mo. to 15 yrs. from the date of surgery. The outstanding results obtained in the histologically unfavourable cases (including the 5 in which surgical removal was incomplete) are further confirmation of how the adequately treated mediastinal neuroblastoma has greater possibilities for being cured than the retroperitoneal one. Age (5 children were under two years) and possible spontaneous maturation of the neoplasm may have played an important role in the favourable outcome as well. Furthermore, in those cases in which the residual neoplasm was subjected to electrosurgical fulguration, a role in the healing process can probably be attributed to immunological factors.