Spontaneous Aortic Rupture in a Malignant Schwannoma

Ea, Bambirra; Miranda, Diego Salcedo

doi:10.1097/00007611-198011000-00035

Cited by 9 publications

(3 citation statements)

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“…There have been previous reports of large schwannomas abutting adjacent structures. These cases have included involvement of the surrounding pulmonary parenchyma causing hemoptysis, aortic and pulmonary artery involvement, as well as a case of a malignant schwannoma invading the thoracic aorta, leading to pathologic aortic rupture and catastrophic hemorrhage ( 4 , 7 , 12 ). To our best knowledge, this is the first case report which describes a mediastinal schwannoma with extensive involvement of the aortic arch, requiring vascular surgery involvement and subclavian interposition bypass.…”

Section: Discussionmentioning

confidence: 99%

“…However, when symptoms do occur, they are often due to involvement and compression of neighboring structures and carry a greater risk of being malignant ( 2 ). Due to the indolent nature of the tumor, schwannomas have the potential to grow large and encase and invade important anatomical surrounding structures, such as the aorta, pulmonary vessels, and left subclavian and innominate arteries, which could lead to catastrophic consequences ( 4 ). This is a case of a large mediastinal schwannoma with significant involvement of the aortic arch requiring extensive surgical resection and vascular reconstruction.…”

Section: Introductionmentioning

confidence: 99%

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Large mediastinal schwannoma with great vessel encroachment requiring vascular reconstruction: a case report

Szewczyk¹,

Hachey²,

Rey³

et al. 2021

Mediastinum

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The most common posterior mediastinal masses are neurogenic tumors such as peripheral nerve sheath tumors (PNST). Schwannomas, a subtype of PNST, are most often benign, well encapsulated tumors of neural crest cell origin, and are frequently incidentally found, ranging in size from small asymptomatic mediastinal tumors to large masses. Rarely, large schwannomas are discovered when symptoms develop due to compression or involvement of nearby structures leading to an array of possible sequela which can include, but not limited to, persistent cough, hemoptysis, and dysphagia. Management decisions are based off of tumor size, location, concern for underlying malignant pathology, and potential for complications related to tumor invasion of vital anatomical structures. A majority of the schwannomas undergo surgical resection, though a subset of small, asymptomatic, benign tumors on imaging or pathology may be managed with surveillance. This case report describes a large posterior mediastinal schwannoma adherent to the posterior aortic arch and encasing the left subclavian and vertebral arteries. Surgical resection required vascular resection of a segment of the left subclavian artery and graft reconstruction using polytetrafluoroethylene (PTFE). This report further highlights the importance of preoperative planning with consideration of a multidisciplinary approach in preparation for resection of large, complex posterior mediastinal masses.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Large mediastinal schwannoma with great vessel encroachment requiring vascular reconstruction: a case report

Szewczyk¹,

Hachey²,

Rey³

et al. 2021

Mediastinum

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“…Chest CT images suggested direct tumor invasion into pulmonary arteries and the superior vena cava. MPNSTs have sometimes demonstrated highly invasive properties such as aortic rupture [10] and aortic aneurysms [11]. With surgical resection, patients with solitary MPNSTs have a 5-year survival rate of 50-75% [1,12,13].…”

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confidence: 99%

Malignant Peripheral Nerve Sheath Tumor of the Mediastinum

Shijubo¹,

Sugaya²,

Imada³

et al. 2000

Respiration

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Malignant “Triton” tumors. Natural history and immunohistochemistry of nine new cases with literature review

Brooks

Freeman

Enterline

1985

Cancer

198

135

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Malignant schwannomas with rhabdomyoblastic differentiation have been termed malignant “Triton” tumors (MTT). To define the natural history of MTT, we have analyzed our experience (9 cases, the largest series reported) in combination with the 27 previously described in the literature (total 36 cases). This study was initiated due to the unusual presentation of MTT as a polypoid esophageal mass. Rhabdomyoblastic differentiation in these tumors was confirmed using myoglobin immunohistochemistry. Two groups of patients were identified: those with Von Recklinghausen's Neurofibromatosis (Group I, VRN cases); and those without (Group II, sporadic, non‐VRN cases). Group I patients accounted for over 70% of cases and displayed a marked male predominance, young age, and common head and neck presentation. By contrast, Group II patients were older, had a female predominance, and tumors frequently located on the trunk. Both groups fared equally poorly: local recurrence was common and the 5‐year survival rate for all cases was 12%. Our data support the view that the natural history of MTT, whether in VRN patients or not, is much more aggressive than sporadic malignant schwannoma and similar to VRN sarcomas in general. This poor outlook could not be attributed to site; rather, it appeared to reflect the high frequency of Grade III histology in this disease.

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Spontaneous Aortic Rupture in a Malignant Schwannoma

Cited by 9 publications

References 0 publications

Large mediastinal schwannoma with great vessel encroachment requiring vascular reconstruction: a case report

Large mediastinal schwannoma with great vessel encroachment requiring vascular reconstruction: a case report

Malignant Peripheral Nerve Sheath Tumor of the Mediastinum

Malignant “Triton” tumors. Natural history and immunohistochemistry of nine new cases with literature review

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