Intrathoracic Giant Mass with Anomalous Vascular Origin in an Asymptomatic Patient: A Case Report

Fabrizio Grignani,Michela Solinas,Valentina Conti

doi:10.3390/surgeries3010001

Abstract

Diagnostic and surgical difficulties were presented in case of a giant mass, found incidentally, in a 65-year-old healthy and asymptomatic man. The patient underwent different diagnostic procedures. Surgery was the treatment of choice. A combination of both open technique and videothoracoscopy to reduce the risk of seeding, pending a certain diagnosis, was resolutive. The postoperative period and recovery time were uneventful. The patient was discharged on the 5th postoperative day. The histological diagnosis was benign schwannoma. There are different aspects to think about, based also on the experience of each center. According to our experience, this is a rare situation; the combined surgical techniques to control the vascular risk and tissue infiltration of the mass seemed to us the approach of choice.

Highlights

Schwannoma is the most common mediastinal neurogenic tumor (50%)
Thoracic schwannomas make up 9% of neurogenic tumors and they are usually localized in the posterior mediastinum, because of their origin from roots of intercostal nerves [1]
This case report shows the usefulness of the combination of the traditional surgical approach and videothoracoscopy to remove a giant schwannoma in a 65-year-old heathy and asymptomatic patient, without serious consequences, as can happen with the traditional technique alone

Summary

Introduction

Schwannoma is the most common mediastinal neurogenic tumor (50%). Generally, the main localizations are the head and neck. Thoracic schwannomas make up 9% of neurogenic tumors and they are usually localized in the posterior mediastinum, because of their origin from roots of intercostal nerves [1]. The peak incidence is between the third and fifth decades of life They affect men and women and, most of the time, they are asymptomatic [2]. There are 10 cases dealing with a giant mediastinal schwannoma in the literature [5] This case report shows the usefulness of the combination of the traditional surgical approach and videothoracoscopy to remove a giant schwannoma in a 65-year-old heathy and asymptomatic patient, without serious consequences, as can happen with the traditional technique alone

Case Presentation

Results

Discussion and Conclusions