Neurogenic tumors

Last revised by Rohit Sharma on 27 Aug 2023

Neurogenic tumors 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 1-3.

  1. peripheral nerve sheath tumors
  2. sympathetic ganglia tumors
  3. paragangliomas

Peripheral nerve sheath tumors and paragangliomas are far more common in adults while the sympathetic ganglia tumors are more common in children.

Peripheral nerve sheath tumors (PNSTs) manifest as round paravertebral masses that span one or two vertebral bodies. They are homogeneous, 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 tumor in adults.

These tumors tend to present as elongated paraspinal masses that span multiple vertebral levels.  Intra-tumoral calcification is common 1-3.

Neuroblastoma and ganglioneuroblastoma are most commonly seen in children and in a child, they comprise the most common neurogenic tumor.

These neuroendocrine tumors are similar histologically to pheochromocytoma and can be functioning or non-functioning 1-2. They are found arising from the base of the skull to the pelvis and are discussed further in the article on paragangliomas.


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