Atypical presentations and neurosurgical Synergy in the treatment of paravertebral tumors in children: Lessons from a single institution.

Background: This study aims to evaluate the surgical management and outcomes of pediatric paravertebral tumors, particularly focusing on dumbbell tumors, within a single medical center.

Methods: Employing a retrospective analysis at Taichung Veterans General Hospital from January 2016 to February 2022, we included pediatric patients diagnosed with paravertebral tumors confirmed via MRI and histopathology, who underwent surgical treatment. We aimed to assess the extent of tumor resection as the primary outcome, with postoperative complications, recurrence rates, and neurological function as secondary outcomes, utilizing descriptive statistics.

Results: In the given period, four pediatric patients, two males and two females aged 53-204 months, were treated at our institute for paravertebral tumors using CT and MRI for diagnosis. The tumors were located in the posterior mediastinum (3 patients) and retroperitoneum (1 patient), with varied MRI findings. Diagnoses included Ganglioneuroma, Schwannoma, Plexiform neurofibroma, and Spindle cell sarcoma. Treatments involved minimally invasive surgeries, with three cases using intraoperative neurological monitoring. Despite a mean operative time of 376 min and a 13-day average hospital stay, one patient experienced recurrence requiring chemotherapy, another had distant metastasis, and one died at a two-year median follow-up.

Conclusions: Our study concludes that CT and MRI are crucial for diagnosing paravertebral tumors and planning surgery, and a multidisciplinary approach is essential for optimal functional preservation in pediatric patients. These findings emphasize the necessity for ongoing research to refine treatment strategies and improve patient outcomes in this complex clinical area.