Nanjo Kazumasa, Sakiyama Shoji, Honda Junko, Hino Hiroyuki
Department of Thoracic Surgery, Kochi National Hospital, Kochi, Japan.
Kyobu Geka. 2024 Aug;77(8):629-633.
An 80-year-old male underwent chest computed tomography (CT) due to complaints of right-sided chest pain. A chest wall tumor was identified in the right eighth intercostal space, corresponding to the location of his pain. The patient was subsequently referred to our department for further evaluation and treatment. Utilizing single-port thoracoscopic surgery, the tumor was successfully excised. Intraoperatively, the tumor was found beneath the parietal pleura, was contiguous with to the intercostal nerve. Histopathological analysis confirmed the diagnosis of schwannoma originating from the intercostal nerve. The right-sided chest pain was reduced after operation significantly. No recurrence or relapse of symptoms was observed during follow-up. Although schwannoma of the chest wall in asymptomatic in many cases, in this case, localized pain corresponding to the tumor site was evident. This emphasizes the importance of considering schwannoma in the differential diagnosis of chest pain.
一名80岁男性因右侧胸痛就诊，接受了胸部计算机断层扫描（CT）检查。在右侧第八肋间发现一个胸壁肿瘤，与他疼痛的部位相对应。随后该患者被转诊至我科进行进一步评估和治疗。通过单孔胸腔镜手术，肿瘤被成功切除。术中发现肿瘤位于壁层胸膜下方，与肋间神经相邻。组织病理学分析确诊为起源于肋间神经的神经鞘瘤。术后右侧胸痛明显减轻。随访期间未观察到症状复发或再发。虽然胸壁神经鞘瘤在许多情况下无症状，但在本病例中，与肿瘤部位相对应的局部疼痛很明显。这强调了在胸痛鉴别诊断中考虑神经鞘瘤的重要性。
