Husodo Septiardhi, Wati Farah Fatma
Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic General Hospital, Surabaya, Indonesia.
Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic General Hospital, Surabaya, Indonesia.
Int J Surg Case Rep. 2023 Aug;109:108564. doi: 10.1016/j.ijscr.2023.108564. Epub 2023 Jul 26.
Mediastinal schwannoma is a rare tumor that develops from a peripheral nerve sheath in the mediastinal.
An Indonesian female, 60 years old, complained of breathlessness, left chest pain, and an intermittent cough. A cystic lesion in the left lung was discovered on radiological evaluation and no evidence of malignancy or metastases were found. The patient underwent a thoracotomy and continued therapy, which included cefixime at a dose of 2 × 200 mg/day, ketorolac at a dose of 3 × 30 mg/day, ranitidine at a dose of 2 × 50 mg/day, and wound care. Histopathology examination revealed a mediastinal schwannoma. For 3 months, the patient-controlled dyspnea, left chest pain, and intermittent cough disappeared once a month.
If the tumor is large enough, a thoracoscopic procedure is advised. Because mediastinal schwannomas are benign tumors, most do not get radiotherapy, chemotherapy, and recurrence in this case has not been reported.
Tissue histopathology is used to determine the diagnosis mediastinal schwannoma, whereas radiological evaluation just confirms the diagnosis. The management is thoracotomy for large masses.
纵隔神经鞘瘤是一种罕见的肿瘤，起源于纵隔内的周围神经鞘。
一名60岁的印度尼西亚女性，主诉呼吸急促、左胸痛和间歇性咳嗽。影像学评估发现左肺有一个囊性病变，未发现恶性或转移证据。患者接受了开胸手术并继续接受治疗，治疗包括每日2次、每次200毫克的头孢克肟，每日3次、每次30毫克的酮咯酸，每日2次、每次50毫克的雷尼替丁以及伤口护理。组织病理学检查显示为纵隔神经鞘瘤。3个月来，患者控制的呼吸困难、左胸痛和间歇性咳嗽每月消失一次。
如果肿瘤足够大，建议采用胸腔镜手术。由于纵隔神经鞘瘤是良性肿瘤，大多数不进行放疗、化疗，且本例未报告复发情况。
组织病理学用于确定纵隔神经鞘瘤的诊断，而影像学评估仅能证实诊断。对于较大肿块的治疗方法是开胸手术。
