Background: Intrathoracic neurogenic tumors (INTs) are derived from nerve tissue and grow within the chest. Preoperative diagnosis can be challenging and only complete surgical exeresis enables confirmation of the suspected diagnosis. Here, we analyzed our experience on management of paravertebral lesions with solid and cystic patterns.
Methods: A monocentric retrospective study was conducted, which included 25 consecutive cases of ITNs in the period from 2010 to 2022. These cases had been surgically treated by thoracoscopic resection alone, or in combination with neurosurgery in the case of dumbbell tumors. The demographic and operative data along with complications were recorded and analyzed.
Results: Twenty-five patients were diagnosed with a paravertebral lesion of which 19 (76%) had solid features and six (24%) had cystic features. The most common diagnosis was schwannoma (72%), followed by neurofibroma (20%) and malignant schwannoma (8%). In four cases (12%) the tumor showed an intraspinal extension. None of the patients had recurrence until 6 months of follow-up. Comparison between the VATS and thoracotomy procedures showed that outcome of discharge on the postoperative day, on average, was 2.61 ± 0.5 versus 3.51 ± 0.53, respectively (p-value <0.001).
Conclusion: The treatment of choice for INTs is complete resection which is tailored to tumor size, location, and extension. In our study, paravertebral tumors with cystic characteristics were not associated with an intraspinal extension and did not show a different behavior from solid tumors.
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http://dx.doi.org/10.1111/1759-7714.14927 | DOI Listing |
Cureus
September 2024
Cardiothoracic Surgery, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, MYS.
Mediastinal mass-like manifestations often cause alarm and instigate a myriad of investigative testing to rule out insidious malignant processes. However, a unique and benign finding, the schwannoma can present either incidentally or while in pursuit of a symptomatic presentation. Given its rarity, limited literature exists on these neurogenic tumours with less than three dozen reported cases.
View Article and Find Full Text PDFActa Neurochir (Wien)
February 2024
Department of Neurosurgery, Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Cardiothorac Surg
November 2023
Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi Yufu, Oita, 879-5593, Japan.
Background: Intrathoracic neurogenic tumors arise from sympathetic nerve trunks and intercostal nerves; more than 90% are benign. Schwannomas are the most common histological variety, but fatalities due to giant schwannomas are rare.
Case Presentation: We report a case of a 65-year-old woman who presented with chest pain and cough.
Interdiscip Cardiovasc Thorac Surg
November 2023
Thoracic Surgery Unit, Department of Surgical Sciences, Santa Maria della Misericordia Hospital, University of Perugia Medical School, Perugia, Italy.
Schwannoma is a benign tumour originating from the Schwann cells. Patients can remain asymptomatic, as the onset of symptoms usually depends on the compressive effect on adjacent organs; dimensional and morphological variability increase the time for the diagnosis. We report the case of a successful surgical resection, performed by video-assisted thoracoscopic surgery, on a patient with radiological evidence of a massive cystic intrathoracic neoformation, histologically revealed to be a peculiar Schwannoma.
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