title: Successful excision of a giant mediastinal vagal schwannoma causing severe tracheal stenosis through a median sternotomy.
abstract: Vagal nerve schwannomas that compress the trachea are extremely rare. We report a case in which a giant middle mediastinal schwannoma accompanied by severe tracheal stenosis was excised. A 70-year-old woman had a 30-year history of hoarseness and paralysis of the left recurrent laryngeal nerve. She presented with chronic cough and dyspnea, which she had experienced for several months. Computed tomography indicated a middle mediastinal mass (8.3×7.1×4.9 cm) that directly compressed the lower trachea, carina, both bronchi, and the left main pulmonary artery. The trachea was 4 mm in diameter at the narrowest point. Through a median sternotomy, the superior vena cava, ascending aorta, right pulmonary artery, and trachea were dissected, and the tumor was excised by gentle dissection. Histologic examination indicated a benign schwannoma.
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: hishiba.thsr@tmd.ac.jp.
authors.forename: Hironori
authors.initials: H
authors.lastname: Ishibashi
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Kumazawa
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Okubo
mesh_terms: D000368:Aged; D001999:Bronchoscopy; D003390:Cranial Nerve Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008479:Mediastinal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D009442:Neurilemmoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D056346:Sternotomy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014135:Tracheal Stenosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014630:Vagus Nerve