A case of robot-assisted surgery for schwannoma of phrenic nerve origin

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  • 横隔神経発症の神経鞘腫に対してロボット支援下手術を施行した1例

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Abstract

<p>Schwannoma is the most frequent mediastinal tumor after thymoma and teratoma, and most often arises in the posterior mediastinum. It usually originates from sympathetic or intercostal nerves, and schwannoma of phrenic nerve origin is rare. The patient was a woman in her 40s who was referred to our department for surgery after computed tomography (CT) in 2021 revealed a mediastinal mass of 4 cm in diameter. Review of previous CT from 2017 identified the mass and confirmed an increase in size over time. Thoracic magnetic resonance imaging showed a low signal intensity on T1-weighted imaging, while T2-weighted imaging showed a high signal intensity at the margins and inhomogeneous low signals in the interior. Positron emission tomography-CT showed focal accumulation of fluorodeoxyglucose (maximum standardized uptake value, 3.95). Based on these imaging results, we suspected a thymoma and performed robot-assisted thymectomy. Since invasion of the left phrenic nerve by a malignant tumor could not be ruled out, we performed combined resection. Rapid pathology revealed schwannoma. The postoperative course was uneventful and the patient was discharged from the hospital on postoperative day 6. We report our experience of a rare case of robot-assisted surgery for schwannoma of phrenic nerve origin.</p>

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