- Case report
- Open Access
- Open Peer Review
Schwannoma of the vagus nerve, a rare middle mediastinal neurogenic tumor: case report
© K Rammos et al; licensee BioMed Central Ltd. 2009
- Received: 28 August 2009
- Accepted: 26 November 2009
- Published: 26 November 2009
Schwannoma originating from the vagus nerve within the mediastinum is a rare, usually benign tumor. A 44-year old male was presented with chest pain. Chest radiography, CT scan and MRI showed a well circumscribed mass, 5 × 4 cm located in the aortopulmonary window. The mass was found at surgery to be in close proximity with the aortic arch and the left pulmonary hilum, alongside the left vagus nerve. The encapsulated tumor was completely resected through a left thoracotomy incision and it was found to be a benign schwannoma in pathology. The patient is free of recurrence 6 years after surgery.
- Aortic Arch
- Vagus Nerve
- Mediastinal Tumor
- Neurogenic Tumor
Neurogenic tumors represent approximately 20% of all adult and 25% of all pediatric primary mediastinal neoplasms. They are divided into nerve sheath, ganglion cell and paraganglionic cell neoplasms . Neurogenic tumors are benign mediastinal tumors with rare exceptions [1–3]. Schwannomas or neurilemmomas originating from the vagus nerve are rare mediastinal tumors, accounting for 2% of all mediastinal neurogenic tumors, arising typically from the nerve sheath and extrinsically compressing the nerve fibers [1, 4].
Scwannomas are lobulated, encapsulated spherical masses, different from neurofibromas in that matter. Men and women are equally affected in their third and fourth decades . Usually, they are asymptomatic and benign, and very rarely malignant or multiple [2–5]. Shwannomas usually arise from a spinal nerve root, indeed they may arise from any other intrathoracic nerve [1, 4]. Radiologically they are sharply demarcated with rare calcifications. CT contrast enhanced scan of the chest shows in accordance, a sharply demarcated mass with low densities and mild enrichment, rarely with calcifications and no fat. On MRI the schwannomas have low - to intermediate signal intensity on T1-weighted images and may have intermediate - to high - signal intensity on T2-weighted sequences [6, 7].
The patient had no postoperative complications and he is free of recurrence 73 months later.
Written informed consent was obtained from the patient for publication of this case-report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
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