Microsurgical Resection of Schwannoma of the Brachial Plexus: A case report / 대한흉부외과학회지

Neurogenic tumors of the brachial plexus region are relatively rare. We report a recent experience of schwannoma of the right brachial plexus in the inferior trunk, which was successfully treated by microsurgical resection. A 38-year- old man presented a dysesthetic pain in the supraclavicular area and the right forearm of C6, 7 dermatome. Rubbery hard mass was palpated in the right supraclavicular area and magnetic resonance imaging showed a well circumscribed, well enhanced ovoid mass with cystic degeneration on the right brachial plexus portion. The patient underwent complete removal of the mass through the anterior cervicothoracic (modified Dartevelle) approach. At the postoperative 3 months, there is no neurologic deficit.

Subarachnoid-Pleural fistula after Excision of Posterior Mediastinal Mass / 대한흉부외과학회지

Subarachnoid-pleural fistula after routine thoracotomy is a rare complication but a very serious problem. Twenty one cases have been reported in the literature. We report a care of subarchnoid-pleural fistula that dveloped after the esecation of posterior mediastinal neurogenic tumor. The patient presented with large amount of clear pleural fluid with mild headache and dizziness. Surgical intervention following a trial of conservative therapy was undertaken because we strongly suspected subarachnoid-pleural fistula. A dural tear was found at the level of resected intercostal nerve root. The dura was closed by way of direct suture and fibrin glue. In this case, the recognition of subarachnoid-pleural fistula formation is difficult because the patient had not presented any neurologic deficit.

Primary Thoracic Neuroblastoma in Children / 대한흉부외과학회지

BACKGROUND: Neuroblastoma is the third most common malignancy of chidhood, and is the most common mediastinal mass in children under the age of 2 years. However, the results of surgical treatment have been seldomly reported in Korea. Therefore, we analyzed the results of surgical treatment in children with neuroblastoma and its influencing factors. MATERIAL AND METHOD: We studied the clinical characteristics and prognosis of 12 children, 11 makes and 1 female, whose primary thoracic neurobalstomas or ganglioneuroblastomas were diagnosed and operated between 1977 and 1997. Men age at presentation was 29.9 months. RESULT: Respiratory symptoms were the modes of performed in 9 patients. Complete excision, partial excision, and biopsy only were performed in 9, 2, and 1 patients respectively. Ten patients of thoractic neuroblastomas survived (83.3%) during follow-up period. CONCLUSIONS: The postoperatve 5-year survival of thoracic neuroblastoma was 76.4% and the prognosis was related to the stage of neuroblastoma. We suggest that complete resection should be considered as preferential method in the treatment of thoracic neuroblastoma in children, especially with early stage.

Malignant Schwannoma on the Right Chest Wall: 1 Case Report / 대한흉부외과학회지

Malignant schwannoma is rare tumor which is derived from schwan cells or nerve sheath cells, and it is frequently associated with Von Rechlinghausen's disease. We experienced one case of malignant schwannoma on the right chest wall without Von Rechlinghausen's disease. Patient was 64-year-old man who presented painless palpable mass on the right lower chest wall for about 2 months. On chest computed tomography, the mass which was 6 X 6 cm in size and had central necrosis, involved 11th rib with destruction, invaded the diaphragm and displaced the kidney anteriorlly. He underwent en-bloc resection of the tumor and discharged without any problem after 20 days.

A Case of Intrapulmonary Neurilemmoma / 대한흉부외과학회지

In this paper, we present an extremely rare case of a primary intrapulmonary neurogenic tumor, in which localization of S-100 protein was investigated using immunohistochemical staining. The patient, who was a 47 year old man, experienced no symptoms, however, a routine chest X-ray revealed a round tumor like shadow in the hilar area of left lung. To confirm and cure the mass, surgery was performed. Histopathological examination of the excised tumor revealed it to be a primary intrapulmonary neurilemmoma. Immunohistochemical staining demonstrated the presence of S-100 protein in the tumor cells.