Eur J Cardiothorac Surg 2003;24:1030
© 2003 Elsevier Science NL
Images in cardio-thoracic surgery |
Giant schwannoma of the posterior mediastinum
Georgios P. Georghioua*,
Bernardo A. Vidnea,
Olga Boikovb,
Milton Sautea
a Department of Cardiothoracic Surgery, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49100, Israel
b Department of Pathology, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49100, Israel
Received 13 June 2003;
received in revised form 26 August 2003;
accepted 1 September 2003.
* Corresponding author. Tel.: +972-3-937-6701; fax: +972-3-924-0762
e-mail: georgios{at}clalit.org.il
Key Words: Schwannoma • Tumors of the posterior mediastinum • Tumors of peripheral nervous system origin
Resection of a mediastinal tumor (Fig. 1)
in a 57-year-old woman who presented with progressively aggravated dyspnea at rest, productive cough, and a referred vague left chest pain, established the diagnosis of schwannoma (Fig. 2
a,b), a benign, slow-growing neoplasm that frequently arises from a spinal nerve root but may involve any thoracic nerve.
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Fig. 1. Antero-posterior view chest X-ray representing the length of the tumor (black arrows). Inset: chest CT scan of the giant (12x14 cm), encapsulated, heterogeneous, posterior mediastinal tumor (white arrows) arising from the paraspinal sulcus. Note calcified areas within the tumor (black arrows). The tumor compresses the upper lobe of the left lung and displaces the mediastinum, with subocclusion of the main pulmonary artery.
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Fig. 2. (a) Encapsulated giant schwannoma (11.5x12.5x14 cm) with cystic areas (white arrows), weighing 650 g. (b) Typical area of schwannoma presented by area of Antoni type A tissue with palisading of spindle cell (filled arrows) and organoid arrangement (Verocay bodies). Isolated cells with bizarre hyperchromatic nuclei (empty arrow) are evident. This sign of degenerative change is common in schwannomas.
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