Schwannoma of the Intercostal Nerve Manifesting as Chest Pain

Feng, Wei-Hsiang; Liu, Tung; Huang, Tsai-Wang; Chen, Yingyi

doi:10.1016/j.athoracsur.2020.02.044

Cited by 9 publications

(3 citation statements)

References 6 publications

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“…The intercostal schwannoma is an uncommon tumor of the chest wall. It is usually painless but may incur intermittent pain in some cases [ 16 ]. It is slow growing and its prevalence is similar across both sexes.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Examination Facilitated the Diagnosis of an Intercostal Schwannoma

Wu¹,

Chang²,

Özçakar³

2022

Cureus

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Ultrasound imaging is known for its capability in scrutinizing superficial soft tissue disorders. We report a rare case of a 71-year-old male who presented with a history of rectal cancer with lymph node metastasis and had complete remission after surgery and chemotherapy. He had a palpable mass over the right anterior lower chest, which became gradually painful in the recent six months. Ultrasound facilitated the diagnosis of an intercostal schwannoma, which was also evident on magnetic resonance imaging and was confirmed by the histopathological study. Following the tumor excision, the patient had complete pain relief at the second-month follow-up. The case report highlighted the usefulness of ultrasound in clarification of the exact location of a chest wall tumor in relation to ribs, pleura, adjacent muscles, and intercostal neurovascular bundles as well as delineation of its echotexture and internal vascularity.

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Section: Discussionmentioning

confidence: 99%

Ultrasound Examination Facilitated the Diagnosis of an Intercostal Schwannoma

Wu¹,

Chang²,

Özçakar³

2022

Cureus

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“…Type of surgical approach depends on the location of the mass and its dimensions: minimally invasive surgery, such as video-assisted thoracic surgery (VATS) or robotic-assisted thoracic surgery (RATS), can be offered if the mass is small and it develops towards the pleural cavity ( Figure 5 ), while thoracotomy is indicated for larger masses or for those tumors which develops in the subcutaneous chest wall or into the intercostal space. The aim is an en - bloc excision of the mass which may require important tissue demolition (i.e., rib resection or even laminectomy if the mass involves the neural root) ( 79 - 83 ).…”

Section: Tumor Originating From Soft Tissuementioning

confidence: 99%

Benign tumors of the chest wall

Minervini,

Sergi,

Scarci

et al. 2024

J Thorac Dis

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Benign tumors of the chest wall are rare tumors that might arise from all the tissues of the chest: vessels, nerves, bones, cartilage, and soft tissues. Despite benign features, these tumors can have several histological characteristics and different behaviors. Even if they do not influence life expectancy, rarely they may have a potential risk of malignant transformation. They can cause several, oft, unspecific symptoms but more than 20% of affected patients are asymptomatic and are being diagnosed incidentally on chest radiograph or computed tomography scan. Pain is the most common described symptom. Together with a detailed medical history, a rigorous and meticulous clinical and radiological assessment is mandatory. If radiological features are unclear or in case surgery could not be performed, a biopsy should be indicated to establish a diagnosis. Radical surgical resection can often be offered to resect and cure these neoplasms, but this is might not be true for all types of tumors and, in some cases, their dimension or position might contra-indicate surgery. Given the rarity of these tumors, there is a lack of treatment’s guidelines and prospective trials that include a significant number of patients. This review discusses, according to the latest evidence, the histological features and the best treatment of several chest wall benign tumors.

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“…Chest wall schwannomas are rare, arising in this location from spinal or intercostal nerves. 2,3 These lesions are typically well encapsulated, slow growing, and result in painless masses usually measuring less than 5 cm. 4 During their growth, they may remodel the costovertebral junction if they arise from a spinal nerve root or the inferior rib edge when the source is an intercostal nerve.…”

mentioning

confidence: 99%

Carbon-Assisted Minimally Invasive Transtubular Approach for Intercostal Nerve Schwannoma

Landriel,

Padilla Lichtenberg,

Ulloque-Caamaño

et al. 2023

Operative Neurosurgery

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BACKGROUND AND OBJECTIVES: The intraoperative localization of an intercostal nerve schwannoma (INS) is extremely difficult because the lesion is generally not palpable, and the fluoroscopic visualization of anatomic landmarks in the ribs is unsatisfactory. Using activated carbon suspension to mark the soft-tissue approach could improve INS localization. We present a novel, simple, reproducible carbon-assisted minimally invasive transtubular approach for an INS. METHODS: The patient was a 57-year-old man with a painful 12th left INS arising below the floating rib. A computed tomography image–guided, tumor-to-skin marking with aqueous carbon suspension was performed 48 hours before surgery. A minimally invasive transtubular approach following the carbon path allowed a precise tumor location. RESULTS: The INS was completely removed. The patient's thoracic radicular pain was immediately relieved after surgery. He was discharged the following day with residual numbness on the left thoracic side. At the 5-year follow-up, no tumor recurrence was noted in the control MRI. CONCLUSION: This article presents an alternative novel technique for resecting an intercostal schwannoma. Using a transtubular approach with carbon-marking assistance allowed a tumor gross total resection with immediate pain relief and a successful outcome.

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Schwannoma of the Intercostal Nerve Manifesting as Chest Pain

Cited by 9 publications

References 6 publications

Ultrasound Examination Facilitated the Diagnosis of an Intercostal Schwannoma

Ultrasound Examination Facilitated the Diagnosis of an Intercostal Schwannoma

Benign tumors of the chest wall

Carbon-Assisted Minimally Invasive Transtubular Approach for Intercostal Nerve Schwannoma

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