[Sympathetic Nerve Trunk Preserved by Intracapsular and Transcapsular Resection in a Patient with Superior...

A 52-year-old man was referred to our hospital because of an abnormal shadow on a chest X-ray. He was asymptomatic. Computed tomography (CT) revealed a smooth 32 mm right superior mediastinal mass at the level of the first to third thoracic vertebrae. T2 magnetic resonance imaging (MRI)revealed a cystic mass with a fluid level. Foregut cysts were initially considered. After three years, the mass had enlarged to 39 mm. Thoracoscopic surgery was performed, and the mass was originated from a sympathetic trunk and removed via intracapsular and transcapsular resection. A histological examination confirmed a diagnosis of schwannoma. The patient experienced no postoperative neurological complications. Intracapsular and transcapsular resection of schwannomas is useful for preventing nerve and vascular injuries.