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Large mediastinal schwannoma with great vessel encroachment requiring vascular reconstruction: a case report

The most common posterior mediastinal masses are neurogenic tumors such as peripheral nerve sheath tumors (PNST). Schwannomas, a subtype of PNST, are most often benign, well encapsulated tumors of neural crest cell origin, and are frequently incidentally found, ranging in size from small asymptomati...

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Autores principales: Szewczyk, Joanne B., Hachey, Krista, Rey, Jorge, Nguyen, Dao M., Villamizar, Nestor R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8794395/
https://www.ncbi.nlm.nih.gov/pubmed/35118342
http://dx.doi.org/10.21037/med-20-71
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author Szewczyk, Joanne B.
Hachey, Krista
Rey, Jorge
Nguyen, Dao M.
Villamizar, Nestor R.
author_facet Szewczyk, Joanne B.
Hachey, Krista
Rey, Jorge
Nguyen, Dao M.
Villamizar, Nestor R.
author_sort Szewczyk, Joanne B.
collection PubMed
description The most common posterior mediastinal masses are neurogenic tumors such as peripheral nerve sheath tumors (PNST). Schwannomas, a subtype of PNST, are most often benign, well encapsulated tumors of neural crest cell origin, and are frequently incidentally found, ranging in size from small asymptomatic mediastinal tumors to large masses. Rarely, large schwannomas are discovered when symptoms develop due to compression or involvement of nearby structures leading to an array of possible sequela which can include, but not limited to, persistent cough, hemoptysis, and dysphagia. Management decisions are based off of tumor size, location, concern for underlying malignant pathology, and potential for complications related to tumor invasion of vital anatomical structures. A majority of the schwannomas undergo surgical resection, though a subset of small, asymptomatic, benign tumors on imaging or pathology may be managed with surveillance. This case report describes a large posterior mediastinal schwannoma adherent to the posterior aortic arch and encasing the left subclavian and vertebral arteries. Surgical resection required vascular resection of a segment of the left subclavian artery and graft reconstruction using polytetrafluoroethylene (PTFE). This report further highlights the importance of preoperative planning with consideration of a multidisciplinary approach in preparation for resection of large, complex posterior mediastinal masses.
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spelling pubmed-87943952022-02-02 Large mediastinal schwannoma with great vessel encroachment requiring vascular reconstruction: a case report Szewczyk, Joanne B. Hachey, Krista Rey, Jorge Nguyen, Dao M. Villamizar, Nestor R. Mediastinum Case Report The most common posterior mediastinal masses are neurogenic tumors such as peripheral nerve sheath tumors (PNST). Schwannomas, a subtype of PNST, are most often benign, well encapsulated tumors of neural crest cell origin, and are frequently incidentally found, ranging in size from small asymptomatic mediastinal tumors to large masses. Rarely, large schwannomas are discovered when symptoms develop due to compression or involvement of nearby structures leading to an array of possible sequela which can include, but not limited to, persistent cough, hemoptysis, and dysphagia. Management decisions are based off of tumor size, location, concern for underlying malignant pathology, and potential for complications related to tumor invasion of vital anatomical structures. A majority of the schwannomas undergo surgical resection, though a subset of small, asymptomatic, benign tumors on imaging or pathology may be managed with surveillance. This case report describes a large posterior mediastinal schwannoma adherent to the posterior aortic arch and encasing the left subclavian and vertebral arteries. Surgical resection required vascular resection of a segment of the left subclavian artery and graft reconstruction using polytetrafluoroethylene (PTFE). This report further highlights the importance of preoperative planning with consideration of a multidisciplinary approach in preparation for resection of large, complex posterior mediastinal masses. AME Publishing Company 2021-12-25 /pmc/articles/PMC8794395/ /pubmed/35118342 http://dx.doi.org/10.21037/med-20-71 Text en 2021 Mediastinum. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
spellingShingle Case Report
Szewczyk, Joanne B.
Hachey, Krista
Rey, Jorge
Nguyen, Dao M.
Villamizar, Nestor R.
Large mediastinal schwannoma with great vessel encroachment requiring vascular reconstruction: a case report
title Large mediastinal schwannoma with great vessel encroachment requiring vascular reconstruction: a case report
title_full Large mediastinal schwannoma with great vessel encroachment requiring vascular reconstruction: a case report
title_fullStr Large mediastinal schwannoma with great vessel encroachment requiring vascular reconstruction: a case report
title_full_unstemmed Large mediastinal schwannoma with great vessel encroachment requiring vascular reconstruction: a case report
title_short Large mediastinal schwannoma with great vessel encroachment requiring vascular reconstruction: a case report
title_sort large mediastinal schwannoma with great vessel encroachment requiring vascular reconstruction: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8794395/
https://www.ncbi.nlm.nih.gov/pubmed/35118342
http://dx.doi.org/10.21037/med-20-71
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