A 42-year-old male who is scheduled to undergo elective knee surgery has a preoperative chest film that demonstrates a 5-cm. posterior mediastinal mass. The patient denies any neurologic symptoms and physical examination fails to elucidate any neurologic deficit. CT confirms the presence of a 5-cm. mediastinal mass in the left costovertebral gutter with minimal enlargement of the seventh thoracic foramen. Appropriate intervention includes:
A. Resection of the posterior mediastinal mass using a standard posterolateral incision.
B. A CT with myelography or magnetic resonance (MR) imaging.
C. Two-stage removal of the tumor, performing the resection of the thoracic component first with subsequent removal of the spinal column component at a later date.
D. One-stage removal of the dumb-bell tumor, excising the intraspinal component prior to resection of the thoracic component.
Answer:B
A 42-year-old male who is scheduled to undergo elective knee surgery has a preoperative chest film that demonstrates a 5-cm. posterior mediastinal mass. The patient denies any neurologic symptoms and physical examination fails to elucidate any neurologic deficit. CT confirms the presence of a 5-cm. mediastinal mass in the left costovertebral gutter with minimal enlargement of the seventh thoracic foramen. Appropriate intervention includes:
A. Resection of the posterior mediastinal mass using a standard posterolateral incision. B. A CT with myelography or magnetic resonance (MR) imaging. C. Two-stage removal of the tumor, performing the resection of the thoracic component first with subsequent removal of the spinal column component at a later date. D. One-stage removal of the dumb-bell tumor, excising the intraspinal component prior to resection of the thoracic component.