胸腔内迷走神経より発生した神経鞘腫の2例

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  • TWO CASES OF MEDIASTINAL SCHWANNOMA ORIGINATING FROM THE INTRATHORACIC VAGAL NERVE

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This paper presents two cases of mediastinal schwannoma originating from the intrathoracic vagal nerve together with a review of 65 cases given detailed explanations in the Japanese literature. The first case: A 48-year-old man was admitted to the hospital because of an abnormal shadow in a chest X-ray film. Under a diagnosis of left mediastinal tumor, an operation was carried out. The tumor and string attached to the tumor were resected en bloc through a thoracotomy. Pathological diagnosis was schwannoma. Left recurrent nerve paralysis was evident by postoperative horseness. We thought that the tumor was a schwannoma arising from the vagal nerve proximal to the origin of the recurrent nerve. The second case: A 51-year-old woman was admitted to the hospital because of an abnormal shadow in a chest X-ray film. From a CT scan and a MRI we diagnosed preoperatively that the tumor arose from the vagal nerve distal to the origin of the recurrent nerve. Thoracoscopic surgery was performed. The tumor was resected with transection of the vagal nerve. Pathological diagnosis was schwannoma. The postoperative course was uneventful. Mediastinal schwannoma originating from the intrathoracic vagal nerve presents difficulty in preoperative diagnosis. Although it uncommonly appears, some malignant cases have been reported and hence complete resection is desirable. However, we have to consider treatments which differ from case to case in terms of postoperative complications.

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