A Resected Case of Multiple Schwannomas Arisen in the Upper Mediastinum along the Vagus Nerve

Abstract

A 46-year-old woman was referred to our department because a plain chest CT scan at another hospital incidentally revealed a mass lesion in the upper mediastinum. This was a rare imaging finding in which two tumors were present as if they sandwiched both the left common carotid artery and the subclavian artery from the anterior and posterior sides. The diagnosis of schwannoma was obtained by trans bronchial biopsy, and robotic-assisted surgery was indicated so that minimally invasive resection could be achieved, if they would remain as they were. On the cephalic side of the hemi-azygos vein, two ridging tumors were detected near the vagus nerve and were resected under the capsule while preserving the nerve. Another small tumor was found on the cranial side and resected in the same manner. Finally, these three tumors were determined to be linked up closely like a rosary. The pathological examinations showed all three tumors were schwannomas with no malignant findings. She had no skin lesions or auditory nerve tumors, and her family history of any neurogenic tumor was negative. The patient is now under observation with the diagnosis of multiple schwannomatosis. We report the case with a review of the literature.