Cervicothoracic vagal neurilemoma: report of a case

[Intrathoracic vagal nerve schwannoma preoperative diagnosis is correct because of clinical and characteristic CT findings--a case report and review of the literature]

A 60-year-old man was operated with the clinical diagnosis of intrathoracic vagal nerve schwannoma because of characteristic CT findings and no symptom of neurofibromatosis. Thoracoscopic surgery was performed and it was confirmed pathologically. Intrathoracic vagal nerve tumor is rare, so preoperative diagnosis seems to be difficult. We review the intrathoracic vagal nerve tumors reported in Japan (52 cases of schwannoma and 9 cases of neurofibroma), and analyzed the tumor location, furthermore, the relationship of neurofibromatosis and schwannoma and neurofibroma on vagal nerve tumor.

[Schwannoma of the intrathoracic vagus nerve]

Schwannomas, or neurilemomas, are tumors that originate in the sheaths covering peripheral nerve fibers. They are usually encapsulated, slow growing, and asymptomatic. Such tumors may appear in any nerve, although most are found in the extremities. Intrathoracic vagus schwannomas are very rare and only 72 cases have been reported. We present a new case in a 39-year-old man in whom chest film showed a well-defined, homogeneous mass measuring 3 cm in diameter located in the left para-aortic region. The presence of a smooth tumor on the vagus nerve and recurrent loop was confirmed by left lateral thoracotomy. After removal, the tumor was shown to be a vagal nerve schwannoma.