2018 Volume 32 Issue 4 Pages 504-511
We herein report the case of a 49-year-old man who presented with an abnormal shadow in the right mediastinum on a chest radiograph. Computed tomography findings revealed a teardrop-shaped, cystic-like, enhanced cervico-mediastinal tumor, of 3.5×3.5×9.5 cm in diameter. The tumor exhibited a high signal intensity on T2-weighted images, and a structure with mixed low and high signals was recognized internally. The patient underwent surgery, and on the -basis of the intraoperative findings, the tumor was pathologically diagnosed as a schwannoma derived from the right vagus nerve. To preserve the vagus nerve, the tumor between the capsules was resected using a cervical approach. Specifically, the neural epithelium was dissected, and only the tumorous nerve fiber bundle was removed. The patient post-surgically suffered from a mildly hoarse voice that he recovered from after one month, and did not suffer from any major complications such as recurrent laryngeal nerve paralysis or Horner's syndrome. Intercapsular resection using a cervical approach should be considered to avoid complications and any deterioration in the quality of life of patients with cervico-mediastinal schwannoma of the vagus nerve.
