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  • Title: Laparoscopic management of a posterior mediastinal tumor mimicking an adrenal neoplasm.
    Author: Berber E, String A, Garland AM, Engle K, Siperstein A.
    Journal: Surg Endosc; 2000 Jul; 14(7):680. PubMed ID: 11290983.
    Abstract:
    BACKGROUND: Rarely, a posterior mediastinal mass may mimic an adrenal tumor on preoperative computed tomography scan. The intraoperative discovery that a mass thought to be associated with the adrenal gland actually is above the diaphragm in the posteroinferior mediastinum poses a challenge for the laparoscopic surgeon. Conversion to a thoracotomy or to videothoracoscopy incurs additional morbidity and risk for the patient. MATERIALS AND METHODS: We describe a technique for the transdiaphragmatic removal of a benign mass from the posterior mediastinum. A posterior mediastinal tumor was detected during a laparoscopic procedure for a suspected right adrenal tumor. Frozen section proved benign, and the mass was resected laparoscopically via transdiaphragmatic access to the posterior mediastinum. RESULTS: No complications were noted during or after surgery. The patient was ready for discharge from the hospital on postoperative day 1. CONCLUSIONS: Transdiaphragmatic resection was done successfully instead of conversion to a thoracotomy or thoracoscopic procedure for a benign posterior mediastinal tumor found incidentally during laparoscopic surgery for a presumed adrenal lesion. This transdiaphragmatic approach can be applied to selected benign mediastinal masses.
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