Retrospective Analysis of the Clinical and Image Presentation of Eight Primary Benign Mediastinal Schwannomas

Abstract

Objective: Mediastinal schwannomas sometimes can be confused with other neoplasms in the initial radiological studies, especially when there is a history of cancer in another site and that require a more accurate analysis by computed tomography (CT) or even magnetic resonance (MRI). Our study was aimed to perform a retrospective analysis of the clinical and imaging features in a series of patients with mediastinal schwannomas that were confirmed by histology and immunohistochemistry.Results: We found eight patients, five man and three women with an average age of 51 years. The main signs and symptoms at time of diagnosis were chest pain, dyspnea, cough and dysphagia. CT showed that the tumor was located in the posterior compartment of the chest in 7/8 cases. Tumors >10 cm were more heterogeneous and showed cystic changes. All cases underwent posterolateral thoracotomy and radiological follow-up showed no evidence of recurrence. Histological analysis was the gold standard to confirm diagnosis in addition to at least one neurogenic IHC marker. In conclusion, mediastinal schwannomas are benign encapsulated tumors. By CT, schwannomas >10 cm showed cystic degeneration more frequently. Posterolateral thoracotomy allows complete resection and is considered the surgical approach of choice.