Key Points

• Neurogenic tumors in the adult are commonly of nerve sheath origin and the majority are benign.
• Children and young adults are more prone to tumors of the autonomic ganglia, which are frequently malignant.
• Nerve sheath tumors comprise one fifth of all mediastinal tumors. The majority of these are either schwannomas (also known as neurilemmomas) or neurofibromas.
• Tumors arising from autonomic ganglia are classified into three histologic types: ganglioneuroma, ganglioneuroblastoma, and neuroblastoma.
• von Recklinghausen’s neurofibromatosis is the only known predisposing factor for benign and malignant neurogenic tumors.
• Surgery plays a dominant role in the treatment of for neurogenic tumors.
• Intraspinal extension of neurogenic tumors must be recognized preoperatively and requires a combined posterior spinal and thoracic approach for safe resection.
• Benign neurogenic tumors are good candidates for minimally invasive methods of resection (thoracoscopic [VATS] or robotic) whereas very large or malignant lesions should likely be approached via open exposures.