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. 2005 Oct 6:3:65.
doi: 10.1186/1477-7819-3-65.

Malignant schwannoma of the upper mediastinum originating from the vagus nerve

Fumihiro Shoji  1 , Riichiroh Maruyama, Tatsuro Okamoto, Hiroshi Wataya, Kenichi Nishiyama, Yukito Ichinose
Affiliations

Malignant schwannoma of the upper mediastinum originating from the vagus nerve

Fumihiro Shoji et al. World J Surg Oncol. .

Abstract

Background: Malignant schwannoma of the upper mediastinum originating from the vagus nerve is extremely rare.

Case presentation: A 46-year-old female was admitted for a left cervical mass which was associated with both hoarseness and Horner's syndrome. Chest computed tomography showed a mass extending from the left upper mediastinum to the left supraclavicular area. A fine needle aspiration cytological examination suggested primary lung cancer stage IIIB large cell carcinoma. After administering induction chemo-radiotherapy, a complete surgical resection was performed. The tumor was found to involve both the left vagus nerve and the left sympathetic nerve. Histological examination of the resected specimen revealed the tumor to be malignant schwannoma.

Conclusion: Despite incorrect preoperative diagnosis, the multimodality treatment administered in this case, including induction chemo-radiotherapy and surgery, proved to be effective.

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Figures

Figure 1
Figure 1
Aspiration cytology of the tumor before treatment showing scattered atypical spindle cells (arrows) (Giemsa staining, high power view x400).
Figure 2
Figure 2
Chest CT showed a mass, measuring 5.0 cm in size in the upper mediastinum.
Figure 3
Figure 3
Macroscopic findings of the tumor. The tumor showing the continuity of the vagus nerve (arrow head) was whitish in color and oval shaped while measuring 5 × 3 cm in diameter.
Figure 4
Figure 4
Histological findings of the tumor. 4A) The tumor was found to consist of a few of viable atypical spindle cells with hyperchromatic nuclei (Hematoxilin-eosin staining x200) 4B). Tumor cells were positive for S-100 protein (immunohistochemical staining, original magnification: X200).
See this image and copyright information in PMC

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