Abstract
A 77-year-old male was identified as having a 4.5cm middle mediastinal tumor in the subcarinal region on chest CT by medical examination for the detection of pulmonary metastasis of caecal cancer. Gadolinium (Gd)-DTPA-enhanced MRI showed the tumor with the Target Sign, i. e., signal intensity of the mass was low on T1-weighted MRI, and the center of the mass was enhanced by Gd-DTPA. A neurogenic tumor was suspected on radiological findings. Transbronchial needle aspiration biopsy (TBNA) and endoscopic ultrasonography-guided fine needle aspiration biopsy (EUS-FNA) were performed, but did not lead to a definitive diagnosis. For the diagnostic and therapeutic modality, resection of the tumor by open thorachotomy was performed. The tumor was diagnosed as Schwannoma originating from the left vagus nerve by operative findings and on pathological examinations. In the preoperative diagnosis of the middle mediastinal tumor, it was suggested that both radiological examinations and aspiration biopsies such as TBNA and EUS-FNA were useful.
