A case of intrathoracic beaded schwannomas originating from multiple intercostal nerves

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  • 複数の肋間に数珠状に多発した胸腔内神経鞘腫の1切除例

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Abstract

<p>A nodule shadow of the right apex area was pointed out on a chest rodiograph of a woman in her 30s during a health examination. Three nodular lesions that were clearly bounded and internally heterogeneous were observed in the right first and second intercostal spaces on chest CT. On chest T2-weighted MRI, the interior showed a high signal intensity. Surgery was performed based on the suspicion of a neurogenic tumor with lymphangioma or cystic change. During surgery, smooth-surfaced nodular lesions that were continuous with the first intercostal and second intercostal nerves were observed, and all lesions were removed under specular conditions. A pathological examination revealed a mixture of Antibiotic Arrangement (Antoni A) showing spinal cells of spindle cells with poor dysplasia and a part that mainly contained mucous organisms (Antoni B), some of which showed cystic changes and vitreous wall glass. Thus, the patient was diagnosed with schwannoma. Intrathoracic nerve sheath tumors account for only 1% of resected chest wall tumors and are relatively rare. In most cases, schwannoma occurs as an isolated tumor; reports of multiple schwannomas occurring in multiple intercostal spaces are extremely rare. We herein review the literature on multiple schwannomas located in the thoracic cavity.</p>

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