Removal of a T1-2 Neurilemmoma by Lateral Parascapular Extrapleural Approach

ABSTRACT

The authors report a case of T1-2 neurilemmoma removed by lateral parascapular extrapleural approach. A 28-year-old man was presented with smooth, well-marginated radiopaque mass in left superior mediastinum on plain chest X-ray. Magnetic resonance imaging revealed a sharply marginated isosignal lesion in the left thoracic inlet on T1 weighted image and strong enhancement on T1 enhanced image. A 15cm length hockey stick skin incision was made from C7 to T9 level. A 2x3cm sized orange colored soft tissue mass was detected over the pleura. The intercostal nerve, subclavian artery, and internal carotid artery were adherent with mass. After gentle dissection, the tumor was removed from nerve bundle. Pathologic examination of tumor revealed a neurilemmoma. The patient was discharged 3 weeks after operation without neurologic deficit.