Benign pleural schwannoma presenting with a large, blood-stained pleural effusion

Bibby, Anna; Daly, Richard; Internullo, Eveline; Edey, Anthony; Maskell, Nick A

doi:10.1136/thoraxjnl-2017-211102

Cited by 6 publications

(8 citation statements)

References 4 publications

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“…Though other PSNTs can initially present with symptoms of pain, palpable/visible mass, or nerve palsy [ 6 ], pleural schwannomas have largely been known to be asymptomatic. Some other cases have reported symptoms such as shortness of breath, cough, hemoptysis, and pleural effusion [ 1 - 4 ]. In our case, the patient presented with musculoskeletal-type pain only, which was not seen in previous cases.…”

Section: Discussionmentioning

confidence: 99%

“…They are commonly found in adults in the third to a fourth decade, with increased incidence in males [ 3 ]. Diagnosis of pleural schwannoma is usually incidental as they are often solitary, slow-growing, benign, asymptomatic tumors [ 4 ]. Here we report a case of primary pleural schwannoma in a 33-year-old female, found on a chest CT scan after reporting months of intermittent left-sided musculoskeletal type chest pain.…”

Section: Introductionmentioning

confidence: 99%

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Pleural Schwannoma Presenting As Musculoskeletal Type Pain: A Case Report

El-Husari¹,

Tabbaa²,

Ibrahim³

et al. 2023

Cureus

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Schwannomas are benign peripheral nerve sheath tumors typically found in the neck, flexor surfaces of the extremities, mediastinum, posterior spinal roots, cerebellopontine angle, and retroperitoneum. Pleural schwannomas are a type of neoplasm that arises from autonomic nerve fiber sheaths in the pleura and rarely originate in the thoracic cavity. These schwannomas tend to be asymptomatic, benign, and slow-growing neoplasms. Although pleural schwannomas commonly occur in males, our report highlights a unique presentation of a pleural schwannoma presenting as musculoskeletal-type chest pain in an adult female. Our patient's diagnosis of pleural schwannoma was supported after X-Ray, Computed Tomography (CT) Scan, and Positron Emission Tomography (PET) Scan imaging was complete. All imagining and immunohistochemical staining yielded pleural schwannoma as the final diagnosis. We aim to bring awareness to the necessity of imaging and histopathological staining in atypical clinical cases of pleural schwannoma. Our novel case highlights pleural schwannoma as a differential diagnosis for patients with intermittent, musculoskeletal-type chest pain.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pleural Schwannoma Presenting As Musculoskeletal Type Pain: A Case Report

El-Husari¹,

Tabbaa²,

Ibrahim³

et al. 2023

Cureus

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“…These effusions can be large in volume and often blood-stained and should not serve as an automatic indicator of malignancy. The possible etiology behind blood-stained effusions has been postulated as spontaneous tumor hemorrhage or rupture [ 4 , 11 , 12 ]…”

Section: Discussionmentioning

confidence: 99%

“…Of an already rare entity, rarer still are the pleural schwannomas, representing approximately 1-2% of thoracic tumors [ 1 , 4 ] and arise from the autonomic nerve fiber sheaths present on the pleural surface of the lung [ 5 , 6 ]. These tumors commonly affect adults with a propensity for the third and sixth decades of life, and a comparative male predilection [ 1 , 4 ]…”

Section: Introductionmentioning

confidence: 99%

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Difficulty Breathing or Just a Case of the Nerves? Incidental Finding of Primary Pleural Schwannoma in a COVID-19 Survivor

Shoaib¹,

Zahir²,

Khan³

et al. 2021

Cureus

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Schwannoma is a rare tumor that arises from the Schwann cells, which are specialized, myelin-producing cells of the peripheral nerve sheaths. As anatomic logic would dictate, these masses commonly occur in the skull base, cerebellopontine angle, and posterior spinal roots. Of this already rare entity, rarer still are the pleural schwannomas, representing approximately 1-2% of thoracic tumors. These tumors commonly affect adults with a propensity for the third and sixth decades of life and a comparative male predilection. Schwannomas are benign, indolent, and follow an asymptomatic course. As such, they often come to light incidentally. Here we report a case of primary pleural schwannomas in a 68-year-old female, found incidentally on a CT scan of the chest. To the best of our knowledge and literature review, no other similar case has been reported in our country, Pakistan. Around three weeks before her presentation, she was diagnosed with COVID-19. Her infection had run a mild course with quick recovery without the need for any hospitalization. Therefore, the manifestation of shortness of breath after resolution of all other symptoms prompted a further workup. Radiographic chest x-ray revealed an incidental finding of a large right upper lobe lung mass, slightly impinging on the trachea. This was followed by a chest CT scan at our radiological imaging facility, which showed a large, well-encapsulated, right upper lobe lung mass in the paraspinal apical location. She then underwent an image-guided biopsy of the aforementioned mass, pathological analysis of which was suggestive of a benign peripheral nerve sheath tumor (PNST) arising from the pleura (pleural schwannoma). She underwent right posterolateral thoracotomy with uneventful complete surgical removal of the pleural-based lung mass. Postoperative investigations included a chest x-ray that showed interval complete resection of the mass. Currently, she is asymptomatic and her clinical condition has improved with the successful resumption of her daily routine. Physicians thus need to keep pleural schwannomas in mind as a probable diagnosis of intrathoracic tumors. Indolent and asymptomatic, they are very amenable to surgical resection with little to no chances of recurrence in the long term. However, these patients should be closely followed with repeat imaging studies when symptomatic.

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