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Sandoval-Macias R, Ortiz-Sanchez ID, Remirez-Castellanos AL, Mora-Hernandez L, Cordova-Uscanga C, Mantilla-Morales A, Galindo-Garcia TA, Gamboa-Dominguez A, Candanedo-Gonzalez F. Retrospective analysis of the clinical presentation and imaging of eight primary benign mediastinal schwannomas. BMC Res Notes 2021; 14:278. [PMID: 34289875 PMCID: PMC8296632 DOI: 10.1186/s13104-021-05694-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 07/14/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Mediastinal schwannomas are sometimes confused with other neoplasms during initial radiological studies, especially when there is a history of cancer in another area. In these cases, a more accurate analysis using computed tomography (CT) or even magnetic resonance (MRI) is required. Our study aimed to perform a retrospective analysis of the clinical and imaging features for a series of patients with mediastinal schwannomas that were confirmed by histology and immunohistochemistry. RESULTS We found eight patients, five men and three women, with an average age of 51 years for this study. The main signs and symptoms at diagnosis were chest pain, dyspnea, cough, and dysphagia. CT showed that the tumor was located in the posterior compartment of the chest in 7/8 cases. Tumors > 10 cm were more heterogeneous and showed cystic changes. All patients underwent posterolateral thoracotomy, and radiological follow-up showed no evidence of recurrence. Histological analysis was considered the gold standard to confirm diagnosis, along with at least one neurogenic IHC marker. In conclusion, mediastinal schwannomas are benign encapsulated tumors. According to CT, schwannomas > 10 cm show cystic degeneration more frequently. Posterolateral thoracotomy allows complete resection and is considered the surgical approach of choice.
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Affiliation(s)
- Ramiro Sandoval-Macias
- AFINES Program to Support and Promote Student Research, Medical School, Ciudad Universitaria, UNAM, Mexico City, Mexico
| | - Irving Daniel Ortiz-Sanchez
- AFINES Program to Support and Promote Student Research, Medical School, Ciudad Universitaria, UNAM, Mexico City, Mexico
| | | | - Luis Mora-Hernandez
- Department of Radiology, UMAE Hospital de Oncologia, Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico
| | - Candelaria Cordova-Uscanga
- Department of Pathology, UMAE Hospital de Oncologia, Centro Medico Nacional Siglo XXI, IMSS, Av. Cuauhtemoc No. 330, Col. Doctores, Delegacion Cuauhtemoc, CP 06725, Mexico City, Mexico
| | - Alejandra Mantilla-Morales
- Department of Pathology, UMAE Hospital de Oncologia, Centro Medico Nacional Siglo XXI, IMSS, Av. Cuauhtemoc No. 330, Col. Doctores, Delegacion Cuauhtemoc, CP 06725, Mexico City, Mexico
| | | | - Armando Gamboa-Dominguez
- Department of Pathology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Fernando Candanedo-Gonzalez
- Department of Pathology, UMAE Hospital de Oncologia, Centro Medico Nacional Siglo XXI, IMSS, Av. Cuauhtemoc No. 330, Col. Doctores, Delegacion Cuauhtemoc, CP 06725, Mexico City, Mexico. .,Department of Pathology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico.
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Malik A, Rajaram M, Vemuri MB, Mohapatra MM, Bh S, V NC. Varied foci of primary benign schwannoma of the thorax: a case series. Monaldi Arch Chest Dis 2021; 91. [PMID: 34286568 DOI: 10.4081/monaldi.2021.1575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 03/06/2021] [Indexed: 11/23/2022] Open
Abstract
Schwannomas are the most common tumor of peripheral nerves. It comprises 1 to 2% of total thoracic tumor. Posterior mediastinum is the most common site in thorax. Hereby we are reporting two cases of schwannoma with different sites of origin. The classical presentation of schwannoma is an asymptomatic mass found on chest radiograph. This tumor is usually benign and slow growing. Imaging followed by histopathological examination is key to the diagnosis of this neoplasm. Resection of tumor cures the disease.
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Affiliation(s)
- Archana Malik
- Department of Pulmonary Medicine, Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry.
| | - Manju Rajaram
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry.
| | - Mahesh Babu Vemuri
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry.
| | - Madhusmita Mohanty Mohapatra
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry.
| | - Srinivas Bh
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry.
| | - Naren Chandra V
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry.
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Yue Y, Xin H, Xu BC, Zhang LN, Zhao W. Posterior mediastinal neurilemmoma accompanied by intrapulmonary sequestration in the left lower lobe: A case report. Medicine (Baltimore) 2019; 98:e16582. [PMID: 31348294 PMCID: PMC6709071 DOI: 10.1097/md.0000000000016582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE The presence of a mediastinal neurilemmoma accompanied by intrapulmonary sequestration is a rare occurrence. The clinical symptoms of a neurilemmoma depend on the site of the tumor. Diagnosis of pulmonary sequestration mainly depends on the presence of aberrant feeding arteries. PATIENT CONCERNS A 78-year-old woman was admitted to our hospital with a mediastinal space-occupying lesion of 50 years. Computed tomography and magnetic resonance imaging showed 2 roundish low-density shadows in the left posterior mediastinum. DIAGNOSIS The pathological findings of the upper cystic mass support the diagnosis of neurilemmoma. A branch of aorta was found supplying blood to the lower mass; it was considered a pulmonary sequestration. INTERVENTIONS Left-sided thoracotomy was planned to remove the chest space-occupying lesions. Two masses were completely removed. Severe adhesion between the left lower lobe and the diaphragm was successfully separated, the aberrant feeding vessel was properly managed, and the lower lobe was resected completely. OUTCOMES The patient experienced remission of symptoms, had no significant postoperative complications, and was discharged from the hospital. LESSONS Special attention should be paid to neurological involvement of the neurilemmoma and the fragile feeding arteries of the intrapulmonary sequestration. Early diagnosis and treatment are important in such cases.
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Affiliation(s)
- Yang Yue
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin
| | - Hua Xin
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin
| | - Bao-Cen Xu
- Department of Thoracic Surgery, People's Hospital of Xing’an League, Ulanhot City, Inner Mongolia autonomous region, China
| | - Le-Ning Zhang
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin
| | - Wei Zhao
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin
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Zhu D, Hong P, Chen S, Fan Y, Zhang Z, Zhang X, Yu W, Shen C, Jin J. Lower posterior mediastinal benign schwannoma successfully resected with retroperitoneoscopy using a transdiaphragmatic approach: A case report. Thorac Cancer 2018; 9:1087-1089. [PMID: 29923676 PMCID: PMC6068460 DOI: 10.1111/1759-7714.12786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 05/13/2018] [Accepted: 05/16/2018] [Indexed: 11/30/2022] Open
Abstract
Lower posterior mediastinal tumors are traditionally excised by conventional thoracotomy or thoracoscopic approaches; however, use of the transdiaphragmatic retroperitoneoscopic approach for these tumors has rarely been reported. Herein, we report a case of a left lower posterior mediastinal paravertebral benign schwannoma in an adult male that was successfully treated with transdiaphragmatic retroperitoneoscopic surgery. The patient presented with no symptoms but had noticed a lesion in the left lower posterior mediastinum two months prior. He underwent transdiaphragmatic retroperitoneoscopic surgery with total resection of the mediastinal mass. To the best of our knowledge, this is the most detailed and challenging case of transdiaphragmatic retroperitoneoscopic surgery to treat a schwannoma in the left lower posterior mediastinum reported to date.
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Affiliation(s)
- Dongdong Zhu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Peng Hong
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Shengbin Chen
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Yu Fan
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Zhongyuan Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Xiaochun Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Wei Yu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Cheng Shen
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
| | - Jie Jin
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China
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