Successful endoscopic surgery to remove a rare nerve sheath tumor

This is a difficult surgery because the tumor is located near many important structures such as the subclavian artery and vein, phrenic nerve, vagus nerve, thoracic duct, and cervicothoracic sympathetic chain.

On September 26, Da Nang Hospital announced that doctors from the Department of Thoracic Surgery had successfully performed endoscopic surgery to completely remove a rare "hourglass" shaped nerve sheath tumor, measuring more than 6cm, located at the top of the left lung - a location where many important blood vessels and nerves are concentrated.

The patient is Mr. Nguyen D.D (born in 1991, residing in Phu Ninh commune, Da Nang city).

Previously, the patient had symptoms of mild ptosis in the left eye but did not go to the doctor.

During a routine health check-up at the company, the patient was found to have an abnormal tumor in the left lung apex through X-ray images and was transferred to Da Nang Hospital for treatment.

CT scan results showed a left paraspinal lesion, involving the D1-D2 intervertebral foramen, located close to important structures such as the subclavian vascular bundle, vertebral artery, and left common carotid artery.

The patient was diagnosed with posterior mediastinal tumor, monitored for nerve sheath tumor, and indicated for endoscopic surgery.

After 2 hours and 30 minutes, the surgery was completed successfully. The patient recovered well, had no post-operative complications and was discharged after a week of treatment. Pathology results confirmed that this was a benign nerve sheath tumor.

Medical staff check the health of patient Nguyen D.D before discharge from hospital. (Photo: VNA)

Specialist Doctor Than Trong Vu, Head of the Department of Thoracic Surgery, who directly performed the surgery, said that this was a difficult surgery because the tumor was located near many important structures such as the subclavian artery and vein, phrenic nerve, vagus nerve, thoracic duct and cervical-thoracic sympathetic ganglion chain.

The risk of complications is high, which can lead to hoarseness, damage to the thoracic duct, cerebrospinal fluid leakage or worsening of ptosis. However, with close coordination between the Thoracic Surgery and Anesthesia team, the surgery was successful thanks to precise manipulation, ensuring maximum safety for the patient.

According to Dr. Vu, schwannoma is the most common tumor in the posterior mediastinum, accounting for more than 75% of nerve tumors in this location.

Most cases progress slowly, have no obvious symptoms and are only discovered by chance.

However, when the tumor is large, it can compress and cause chest pain, difficulty breathing, hoarseness or Horner's syndrome (including ptosis and miosis).

In particular, the "hourglass" shaped tumor is very rare and surgery is difficult due to its involvement with the spinal canal and pleural cavity.

Doctors recommend that people pay attention to unusual symptoms such as drooping eyelids, chest pain, difficulty breathing, prolonged cough... and should go to a specialized medical facility for early detection, diagnosis and treatment to avoid unfortunate complications./.

(TTXVN/Vietnam+)

Source: https://www.vietnamplus.vn/phau-thuat-noi-soi-cat-thanh-cong-khoi-u-vo-bao-than-kinh-hiem-gap-post1064217.vnp