title: Combined minimally invasive approach using microsurgery and thoracoscopic surgery for resecting a dumbbell-type thoracic schwannoma.
abstract: We present a case of a thoracic schwannoma with an intravertebral component, a so-called "dumbbell-type" tumor, that was resected with a combined minimally invasive approach using microsurgery and thoracoscopic surgery simultaneously. A 31-year-old man was admitted to our hospital for treatment of a thoracic schwannoma 45 mm in maximal diameter at the level of the third thoracic vertebra. After the tumor was separated from intravertebral structures by using a microsurgical technique via the posterior approach with a hemilaminectomy and minimal unilateral facetectomy, the mass was removed completely by using video thoracoscopy. We stress that this approach should be the most useful and less invasive technique for treating the dumbbell-type of thoracic neurogenic tumor compared with a single or combination technique involving thoracotomy, multi-level laminectomy and costotransversectomy. Below, we make some notes on this technique from the neurosurgeon's standpoint.
authors.affiliation: Department of Neurosurgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Ishikawa
authors.forename: A
authors.initials: A
authors.lastname: Matsumura
authors.forename: S
authors.initials: S
authors.lastname: Ishikawa
authors.forename: K
authors.initials: K
authors.lastname: Nakamura
authors.forename: T
authors.initials: T
authors.lastname: Nose
mesh_terms: D000328:Adult; D006801:Humans; D007089:Image Enhancement; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery / Q000295:instrumentation*; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D009442:Neurilemmoma / Q000175:diagnosis / Q000601:surgery*; D010524:Peripheral Nervous System Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013126:Spinal Nerve Roots / Q000473:pathology / Q000601:surgery*; D013899:Thoracic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery; D020708:Thoracoscopes