A case of neuroblastoma of the anterior mediastinum in an 81-year-old woman

An 81-year-old woman was pointed out as having an abnormal shadow on chest X-ray. Computed tomography revealed a highly calcified mass lesion in the right anterior mediastinum that was 40 mm in size, and another in the left 30 mm in size. She underwent mass resection with extended thymectomy. Neither mass showed severe adhesion to adjacent organs and both could be completely resected except for the left phrenic nerve. Pathological findings of the left mass showed small round tumor cells, and further immunohistological staining revealed that the tumor cells were positive for neuron-specific enolase, S-100 protein and synaptophysin but negative for cytokeratin, MIC-2, UCHL-1 and L-26, therefore we diagnosed this tumor as a neuroblastoma. Pathological findings of the right mass showed only necrosis and calcification, with no viable cells. Following the operation, 46 Gy of irradiation was performed. About four years after the resection, she died due to the recurrence in the left hemithorax and multiple bone metastases. Neuroblastoma found in an octogenarian is extremely rare, and that arising in the anterior mediastinum is also uncommon.