Mediastinal schwannoma

Abstract

Introduction: Schwannoma is a rare tumor that usually develops from the intercostal nerves. Nine per cent of schwannomas occur in the mediastinum. It is a slow growing lesion usually occurring in young adults. The discovery is often fortuitous. Through this work we highlight the interest of surgery in the diagnostic and therapeutic management of schwannomas.

Methods: This is a retrospective descriptive study of 21 patients operated on for mediastinal schwannoma in the thoracic surgery department of Abderrahman Mami hospital between 2010 and 2020.

Results: There were 15 women and 6 men. The average age was 44.16 years. Symptomatology was made of dyspnea in 5 cases, cough in 2 cases, chest pain in 6 cases, cervicobrachial neuralgia in 2 cases and dysphonia in 1 case. The discovery was fortuitous in 6 cases. A chest x-ray taken for all patients showed mediastinal opacity. All patients had an injected thoracic CT scan which showed a mass of the posterior and superior mediastinum in 18 cases and of the posterior and inferior mediastinum in 3 cases. The average size of the tumor was 60mm[30-110mm]. All patients underwent complete surgical resection of the tumor. Posterolateral thoracotomy was performed in 8 cases, lateral thoracotomy in 1 case, and video assisted thoracoscopy in 12 cases. The postoperative course was uneventful. The mean duration of drainage was 3 days and the duration of hospitalization was 4.16 days. The pathological examination confirmed the diagnosis. No recurrence was reported with a mean follow-up of 4 years.

Conclusion: The treatment of choice for mediastinal schwannomas is complete surgical resection. Its objectives are to confirm the histopathological diagnosis of the tumor, to prevent local invasion, and malignant degeneration