Combined surgical treatment of a giant peripheral nerve tumors of the “hourglass type” of the right cost-vertebral cornar

Paravertebral tumors of mediastinal localization — an extensive group of pathological processes, the surgical treatment of which is carried out by doctors of various specialties, such as neurosurgeons and surgical oncologists. Currently, thoracoscopic removal is considered to be the most preferred method of surgical treatment of these mass formations, in view of the least trauma, fewer complications, and a reduction in the time of postoperative recovery of patients. A clinical case of surgical treatment of a patient with a giant paravertebral tumor originating from the 4^th thoracic root is presented. The tumor was an incidental finding during routine fluorography. There were no focal neurological symptoms. Taking into account the topographic and anatomical features of the volumetric formation, the patient underwent a combined two-stage surgical intervention, where the first stage was laminectomy and removal of the foraminal component of the tumor from the posterior approach, the second stage was single-port video-assisted thoracoscopic removal of the mediastinally located tumor fragment. The operation was performed under conditions of a collapsed lung on the side of the intervention. In the postoperative period, no neurological deficit was noted; according to the control introscopy, the tumor was removed completely. According to the results of histological examination – neurofibroma (Grade I).