2017 Volume 31 Issue 4 Pages 554-560
We report a case of neurofibroma arising from the right first intercostal nerve resected via subclavicular incision and thoracoscopy. The case was a 15-year-old female who had a family history of neurofibromatosis type 1. She had multiple cafe-au-lait spots on the trunk. She was referred to our hospital because of an abnormal shadow in the right lung on a chest radiograph at a school physical examination. Chest computed tomography showed a 5-cm mass in the right first intercostal space and right pleural effusion. Contrast-enhanced magnetic resonance imaging showed a heterogeneously enhanced mass abutting the right subclavian vein.
Tumor resection was successfully performed via an approximately 6-cm subclavicular incision and 3 ports for a thoracoscopic approach without clavicectomy and/or sternotomy. The tumor was fixed to the first rib and resected with a part of the first rib. Pathological examination showed neurofibroma. The combination of the thoracoscopic approach and direct approach through subclavicular incision was useful for safe resection of the tumor with clear visualization of the surgical field.
