Neurogenic tumours are the cause of approximately 90% of posterior mediastinal masses. They can be subdivided into three groups by their location and involvement of peripheral nerves or sympathetic chain.
Peripheral nerve sheath tumours and paragangliomas are far more common in adults while the sympathetic ganglia tumours are more common in children.
Peripheral nerve sheath tumours
These tumours manifest as round paravertebral masses that span one or two vertebral bodies. They are homogenous, soft-tissue attenuation masses at CT and the commonest cause of posterior mediastinal and paravertebral masses. They may cause widening of the neural foramen and thickening of the adjacent posterior rib.
Schwannoma and neurofibroma are by far the most common type of neurogenic tumour in adults.
Sympathetic ganglia tumours
These tumours tend to present as elongated paraspinal masses that span multiple vertebral levels. Intra-tumoural calcification is common.
- neuroblastoma - young children
- ganglioneuroblastoma - older children
- ganglioneuroma - children and adults
Neuroblastoma and ganglioneuroblastoma are most commonly seen in children and in a child they comprise the most common neurogenic tumour.
These tumours are similar histologically to phaeochromocytoma and can be functioning or non-functioning.
- 1. Reed JC, Hallet KK, Feigin DS. Neural tumors of the thorax: subject review from the AFIP. Radiology. 1978;126 (1): 9-17. doi:10.1148/126.1.9 - Pubmed citation
- 2. Kreel L. Goitre and neurofibroma. Postgrad Med J. 1986;62 (728): 463-5. doi:10.1136/pgmj.62.728.463 - Free text at pubmed - Pubmed citation