2020 Volume 34 Issue 1 Pages 13-17
Schwannoma is a benign tumor that often occurs in the posterior mediastinum and arises from the sympathetic or intercostal nerve. The majority of cases are not symptomatic, and an operation is performed without a pathological diagnosis. Case: A 69-year-old woman complaining of a chronic cough underwent computed tomography (CT) for the inspection of a gastric submucosal tumor (SMT). Incidentally, it showed a cyctic tumor on the dorsal side of the left main bronchus, surrounded by the descending aorta and esophagus. We conducted endoscopic ultrasound fine needle aspiration (EUS-FNA) and diagnosed it as a schwannoma pathologically. The nodule affected the bronchial wall, and so was a suspected cause of coughing. We removed the tumor by thoracoscopic surgery, and it was revealed that it originated from the vagus nerve. It is difficult to diagnose a middle mediastinal tumor preoperatively because it could be close to critical organs and vessels. Although needle biopsy involves a risk of bleeding, we could make a preoperative diagnosis. We encountered the rare case of a symptomatic middle mediastinum schwannoma that originated from the vagus nerve.