Objective: To investigate the diagnosis and treatment of the primary tumors at the cervicothoracic junction.
Methods: We analyzed 17 cases of the tumors diagnosed by surgery and histopathology in Chinese PLA General Hospital from Mar. 2005 to Dec.2009. The clinical manifestations, the surgical approaches and surgical complications were analyzed retrospectively.
Results: The main partial of the tumors located in left side in 9 patients and in right side in 8 patients. The operation approaches included the lateral cervical incision (1 patient), the combined cervical and thorax incision (3 patients), the supraclavicular cervical incision (6 patients), the combined cervical incision and superior mediastinotomy (7 patients). Except 3 cases in whom the tumors surrounded or sticked to vital blood vessels or nerves had experienced subtotal resection, the remained 14 cases had total ablation. The morbidity occurred in 5 patients, including subclavian artery, vertebral artery and common carotid artery rupture, recurrent laryngeal nerve trauma, brachial plexus trauma and Horner' syndrome. The histopathology included the cyst, the venous haemangioma, the nodes cell neuroma, the fibroma, the fibrosarcoma, the liposarcoma, the myofibroblastic tumor, the ectopic hamartomas thymoma, the neurofibroma, and neurinoma. All the patients were followed up from 1 to 4.5 years post-operatively, with the mean follow-up of 25.3 months. The two malignant patients were alive being free of tumor with follow-up of 3 year and 8 months, and 2 year respectively. The three cases with tumor partial resection were all alive with tumour. The remained 12 benign cases with total tumor total ablation were all alive free of tumour.
Conclusions: The histopathology of the cervicothoracic junction is diversity. But the commonest pathology is neurinoma. When the tumor is extensive, enveloping or involving the vital blood vessel and nerve, it is difficult to get total ablation, and the morbidity is very high.