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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2021
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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. |
format | Online Article Text |
id | pubmed-8794395 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
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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