Examination of location and operative method of chest wall schwannoma

Abstract

We examined 3 cases of chest wall schwannoma. During operations, 2 cases were located between the parietal pleura and intercostal muscle (subpleural type). One case was located between the internal and external intercostal muscles (intramuscular type). CT scanning (mediastinal condition) findings in the 2 types: The subpleural type exhibited a sharp angle between the chest wall and tumor, smoothness of the tumor surface, and distinctiveness of the tumor structure. However, the intramuscular type exhibited a smooth angle between the chest wall and tumor, roughness of the tumor surface, and indistinctiveness of the tumor structure. Operative methods: Both types could be resected by thoracoscopic surgery. Regarding the subpleural type, first, we cut the parietal pleura around the tumor, then, the capsule of the tumor could be visualized. Next, we peeled beneath the capsle, ligated and cut the steel connected to the intercostal nerve, and resected the tumor. Concerning the intramuscular type, we cut the parietal pleura, split the muscle fibers, and resected the tumor. Under specified conditions, the intramuscular type may be more effectively resected by the extrapleural method. We must consider the appropriate operative method based on the clinical data.