Surgical treatment of paraspinal schwannoma of left supraclavicular fossa: a case report

Hai Zhang,Fengyuan Peng,Hui Li,Wanli Lin,Weibi Che

doi:10.1590/fst.57721

Abstract

The incidence of paraspinal schwannoma of supraclavicular fossa is low, and its operative plan and complications have not been systematic reported. Here, we reported a case of supraclavicular paraspinal schwannoma in our center. The operative methods, intraoperative precautions and postoperative complications were illustrated. A 54 years old male patient was admitted to hospital due to pain in the left chest and back for 20 days. MRI showed 32 × 68 × 38 mm tumor adjacent to the spine of the left supraclavicular fossa. The patient underwent supraclavicular incision surgery, and the postoperative pathology showed schwannoma. After the operation, the nerve of the left upper limb was damaged, which was manifested as numbness in the skin above the joint of the left thumb, left index finger, middle finger, ring finger and little finger. The skin above the second finger joint of the little finger is numb and the grip strength is weakened. One month after operation, the symptoms were relieved. Surgery is the first choice for the treatment of supraclavicular tumors. It is necessary to review the anatomy of supraclavicular region in detail before the operation, and to protect important nerves and vessels during the operation.

Highlights

Supraclavicular schwannoma is a rare disease and its incidence accounts for less than 1% of the head and neck tumors
Chest CT plain scan + enhanced scan showed that an oval slightly low-density mass with a range of about 66 mm × 30 mm was found at the left supraclavicular fossa paraspinal
The possibility of schwannoma should be considered for the left supraclavicular fossa paraspinal space occupying (Figure 2)

Summary

Introduction

Supraclavicular schwannoma is a rare disease and its incidence accounts for less than 1% of the head and neck tumors. Surgical resection is still the main method for the treatment of this disease. Supraclavicular approach is the often used in the surgery. Complete tumor resection and maximum protection of surrounding tissues are important for the success of the surgery. The incidence of supraclavicular neurilemmoma is low, it often causes surgeons to suffer from the special location and complexity of the disease. We reported the operation and postoperative situation of a middle-aged male patient with schwannoma in the left supraclavicular fossa and discussed the selection of surgical approach and the prevention of complications

Case presentation

Surgery

Findings

Discussion