En Yean Len, Krishnasamy Sivakumar, Zhe Sheng Nicolas Ong, Jia Ying Ooi, Kein Seong Mun
Cardiothoracic Unit, Department of Surgery, Universiti Malaya Medical Centre, Petaling Jaya, MYS.
Faculty of Medicine, MAHSA (Malaysian Allied Health Sciences Academy) University, Jenjarom, MYS.
Cureus. 2025 Jul 30;17(7):e89027. doi: 10.7759/cureus.89027. eCollection 2025 Jul.
Schwannomas are benign, well-encapsulated tumors arising from Schwann cells, which are responsible for the myelination of peripheral and central nerves. This report highlights a rare incidence of a T4 thoracic schwannoma with right paraspinal extension into the thoracic cavity. A 77-year-old woman presented with bilateral lower limb weakness; MRI revealed a T3-T5 intradural extramedullary lesion extending from the spinal canal into the right posterior mediastinum. A multidisciplinary surgical approach was employed: the neurosurgical team first performed a posterior laminectomy to resect the intraspinal component, followed by en bloc resection of the intrathoracic tumor via uniportal video-assisted thoracoscopic surgery (VATS) by the cardiothoracic team. This combined approach enabled complete tumor excision and favorable neurological recovery, highlighting the importance of coordinated multidisciplinary management in complex thoracic schwannomas with intraspinal extension.
施万细胞瘤是起源于施万细胞的良性、有完整包膜的肿瘤，施万细胞负责周围神经和中枢神经的髓鞘形成。本报告强调了一例罕见的T4胸段施万细胞瘤，其向右椎旁延伸至胸腔。一名77岁女性出现双侧下肢无力；磁共振成像（MRI）显示一个从椎管延伸至右后纵隔的T3-T5节段硬膜内髓外病变。采用了多学科手术方法：神经外科团队首先进行后路椎板切除术以切除脊髓内部分，随后心胸外科团队通过单孔电视辅助胸腔镜手术（VATS）整块切除胸内肿瘤。这种联合方法实现了肿瘤的完全切除和良好的神经功能恢复，突出了在伴有脊髓延伸的复杂胸段施万细胞瘤中多学科协调管理的重要性。
