Long-Term Survival after Surgical Resection and Radiotherapy for Anterior Mediastinal Neuroblastoma in an Older Patient: A Case Report.
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INTRODUCTION: Neuroblastoma is commonly seen in children younger than 5 years but is extremely rare in adults. There are only 23 reported cases of mediastinal neuroblastoma in adults, and no standard treatment strategy has been established. CASE PRESENTATION: A 79-year-old man was referred to our hospital for the investigation of an abnormal shadow observed on a routine chest radiograph. CT revealed a 5.5 × 5.0-cm mass in the anterior mediastinum, and fluorodeoxyglucose-PET demonstrated increased fluorodeoxyglucose uptake. Surgical resection was performed to obtain a definitive diagnosis and local control. Histopathological examination confirmed that the mass was a poorly differentiated neuroblastoma with invasion into the surrounding mediastinal fat. Postoperative radiotherapy was administered. The patient remains alive without recurrence at more than 5 years after surgery. CONCLUSIONS: Neuroblastoma arising in the anterior mediastinum of adults is extremely rare and the long-term prognosis remains unclear. Complete resection followed by radiotherapy may contribute to prolonged disease-free survival in selected adult patients.