Background: Robot-assisted thoracoscopic surgery (RATS) is useful for surgery in the apical region of the chest\ncavity, as it narrows towards the head. Here, we describe a nonfunctional, rib-invasive paraganglioma arising in the\nposterior mediastinum that was successfully removed using RATS combined with chest wall resection.\nCase presentation: A 31-year-old woman presented with a posterior mediastinal mass on chest computed\ntomography (CT) scan during a medical check-up 2 years prior. Positron emission tomography/computed\ntomography scan with F-18 fluorodeoxyglucose revealed a mass associated with standardized uptake maximum\nvalue of 2.69. With a preoperative diagnosis of neurogenic tumor by CT-guided percutaneous fine-needle aspiration\nbiopsy, we performed robot-assisted tumor resection combined with chest wall resection. The wristed instruments\nof the robotic surgical system have increased range of motion and enabled the tumor resection without organ\ninjury in the thoracic cavity. Histopathology examination revealed a non-functional paraganglioma with rib invasion.\nConclusions: RATS is a useful technique, enabling safer and easier resection of a mediastinal tumor adjacent to\nsurrounding organs.
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