THORACOSCOPIC MICROSURGICAL EXCISION OF A THORACIC SCHWANNOMA - CASE-REPORT

A 6-cm-diameter schwannoma located at T-2 was resected completely by u sing transthoracic microsurgical endoscopy. The partially cystic tumor widened the neural foramen and extended into the apex of the right th oracic cavity but did not extend intradurally. The tumor was accessed by means of three 15-mm incisions made in the intercostal spaces. The operative blood loss was only 200 ml. and there were no complications. The patient was discharged on the 2nd postoperative day and returned to full activity 1 week after surgery. Thoracoscopy provides an excell ent alternative to thoracotomy for peripheral thoracic nerve sheath tu mors that originate within the neural foramen or more distally along t he intercostal nerves within the thorax. An anterior approach is requi red for intrathoracic tumors but is not suited for intradural tumors. An open posterior or posterolateral approach to the thoracic spine is required for intradural tumors to allow the dura to be closed adequate ly.