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Case Reports
. 2020 Nov-Dec;34(6):3527-3532.
doi: 10.21873/invivo.12194.

Giant Intrathoracic Schwannoma: A Case Report

Cornel Savu  1   2 , Vasile Grigorie  3 , Alexandru Melinte  3 , Camelia Diaconu  2   4 , Laura Iliescu  2   5 , Mihai Dimitriu  2   6 , Irina Balescu  7 , Nicolae Bacalbasa  2   8   9
Affiliations
Case Reports

Giant Intrathoracic Schwannoma: A Case Report

Cornel Savu et al. In Vivo. 2020 Nov-Dec.

Abstract

Background/aim: Thoracic neurogenic tumors are most frequently located in the posterior part of the mediastinum or on the chest wall, along the intercostal nerves. Schwannomas are very well tolerated for a long period, until the tumor reaches a large size and compression of the neighbouring mediastinal organs, chest wall or spine appears. The purpose of this article was to present a case of a giant right forth intercostal nerve Schwannoma, completely resected by a right antero-lateral thoracotomy. In addition, intrathoracic giant neurogenic tumors are a rarity.

Case report: The patient presented with only diminished tolerance to physical activity with no other obvious symptoms. Standard chest radiography revealed a well-defined opacity of subcostal intensity, occupying two thirds of the right hemithorax, forming a common body with the mediastinal shadow. Thoracic computed tomography (CT) identified a 21/11 cm solid mass that compresses the right lung and the right main bronchus with both a solid component and a central liquid area. Open surgery was performed in order to remove the tumor, which was 20.5/12.5/9 cm in size and weighed 1,830 g, well defined, with no invasion of the adjacent organs, having a solid-fibromatous aspect as well as a central necrotic area. The origin of the tumor was confirmed from the posterolateral part of the forth intercostal nerve. Pathology examination and immunohistochemistry confirmed the diagnosis of a benign Schwannoma.

Conclusion: Benign intrathoracic Schwannomas are asymptomatic for long periods and the main therapeutic option is complete surgical resection. The surgical approach, either open or video-assisted is dictated by the localisation of the tumor, local extension and most importantly the size of the neurogenic mass.

Keywords: Schwannoma; anterolateral thoracotomy; dumbbell tumor; giant neurogenic tumors.

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Conflict of interest statement

The Authors declare no conflicts of interest regarding this study.

Figures

Figure 1
Figure 1. Standard thoracic radiography – mass in the right hemithorax
Figure 2
Figure 2. Thoracic computed tomography – mass in right hemithorax
Figure 3
Figure 3. Histopathological microscopic view. Magnification ×20
See this image and copyright information in PMC

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