[Diaphragmatic or juxtadiaphragmatic schwannoma?]

Abstract

The authors report one case of schwannoma of diaphragmatic topography. This lesion is exceptional and, to our knowledge, only seven cases have been published in the literature. The first diagnosis was a suprarenal tumour. Magnetic resonance imaging provided more detail about the juxta diaphragmatic topography of the tumour, which was subsequently confirmed by surgery. The diagnosis of benign schwannoma was made at the pathological and immuno-histochemical examination of the specimen. The schwannoma corresponded to the type B of the classification of Antoni. Pathogeny and origin of the tumour are discussed. The sympathetic nervous para-vertebral system, the phrenic or intercostal nerves could be the origin of the tumour. In the eight cases reported, the tumoural removal was performed through thoracotomy (n = 5) or laparotomy (n = 3). The preoperative exact location of the juxta diaphragmatic tumours remains difficult to specify.