Preferred surgical approach for dumbbell-shaped tumors in the posterior mediastinum

We present the case of a 67-year-old male smoker with a posterior mediastinal hemangioma. Radiological findings revealed a dumbbell-shaped tumor with a neuroforaminal extension in the right paravertebral space. Under the preoperative diagnosis of a neurogenic tumor, surgery was performed using a combined anterior and posterior approach. During the thora-cotomy, the tumor was found to be a hemangioma. We ligated the involved vessels before performing laminectomy, thus ensuring that complete tumor resection was achieved without massive bleeding in the spinal canal. Dumbbell-shaped hemangiomas are rare, and preopera-tive confirmation of the diagnosis is challenging. Thoracotomy before laminectomy is optimal for the resection of dumbbell-shaped tumors of the mediastinum, especially with marked vascularity, given that the initial thoracotomy procedures facilitate the subsequent laminec-tomy procedures.