title: Temporary claviculectomy approach for plexiform neurofibroma of the first intercostal nerve.
abstract: Plexiform neurofibroma at the thoracic inlet has rarely been reported and to our knowledge, the use of a temporary middle claviculectomy approach for thoracic inlet tumors has never been reported. We report a case of plexiform neurofibroma of the first intercostal nerve resected using a temporary claviculectomy approach. An abnormal shadow detected radiographically in a 16-year-old boy led to a diagnosis of neurofibromatosis 1 (NF-1) with a chest wall tumor at the thoracic inlet. The patient underwent resection of the tumor with the right first rib. The resected clavicle was reapproximated with a plate and postoperative shoulder function was satisfactory. The tumor was diagnosed pathologically as a plexiform neurofibroma and the patient's postoperative course was uneventful. The temporary middle claviculectomy approach provides excellent exposure of the subclavian vessels and brachial plexus before resection of the tumor. We recommend this approach for tumors of the anterior thoracic inlet.
authors.affiliation: Department of Surgery, Kashiwa Hospital, Jikei University School of Medicine, 163-1 Kashiwashita, Kashiwa, Chiba, 277-8567, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Akiba
authors.forename: Mamoru
authors.initials: M
authors.lastname: Ishiyama
authors.forename: Hideki
authors.initials: H
authors.lastname: Marushima
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Nojima
authors.forename: Susumu
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Morikawa
mesh_terms: D000293:Adolescent; D002968:Clavicle; D005260:Female; D006801:Humans; D007367:Intercostal Nerves / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D018318:Neurofibroma, Plexiform / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D009456:Neurofibromatosis 1 / Q000150:complications*; D013902:Radiography, Thoracic; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed