Successful surgery for rare nerve sheath tumor

DNVN - On September 26, Da Nang Hospital announced that doctors from the hospital's Thoracic Surgery Department had successfully performed endoscopic surgery to completely remove a rare nerve sheath tumor.

Previously, patient Nguyen D.D (born in 1991, residing in Phu Ninh commune, Da Nang city) had a slight drooping of the left eyelid but subjectively did not go to the doctor. During a routine health check at the company, a chest X-ray discovered an abnormal tumor in the left lung apex, so the patient was admitted to the Thoracic Surgery Department, Da Nang Hospital for treatment.

Dr. Than Trong Vu and the team at Da Nang Hospital performed surgery for patient Nguyen D. D.

Chest CT scan revealed a lesion next to the left spine, with clear edges, continuous with the left D1-D2 intervertebral foramen, located close behind the left subclavian artery, left vertebral artery, and left common carotid artery.

The patient was diagnosed with posterior mediastinal tumor, D1-D2 position, followed by an 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. Da Nang Hospital scheduled surgery to remove the tumor using thoracoscopic surgery.

After 2 hours and 30 minutes, the surgery was successful, the patient recovered well, without complications. Currently, the patient is stable, the ptosis condition improved and was discharged after 1 week of treatment. The pathological results showed that this was a case of benign nerve sheath tumor.

Directly performing surgery on the patient, Dr. CKII Than Trong Vu - Head of Thoracic Surgery Department, Da Nang Hospital said that the tumor's location is near important structures: Behind the subclavian artery, subclavian vein, left common carotid artery, X nerve, phrenic nerve, thoracic duct, cervical-thoracic sympathetic ganglion.

“This position is very difficult for surgery. Many complications can occur such as bleeding, hoarseness, cerebrospinal fluid leakage, thoracic duct damage, cervical sympathetic ganglion damage, making the ptosis worse,” said Dr. Than Trong Vu.

The patient's health is now stable.

However, doctors were successful in completely removing the tumor using thoracoscopic surgery.

According to Dr. Than Trong Vu, schwannoma is the most common type of nerve tumor in the posterior mediastinum, accounting for more than 75% of nerve tumors in this location. Usually, these tumors grow slowly, have few symptoms, and many cases are discovered by chance.

When the tumor is large, it can compress and cause chest pain, difficulty breathing, hoarseness or Horner syndrome (ptosis, miosis). In particular, the hourglass-shaped tumor is very rare and difficult to operate because it involves both the spinal canal and the pleural cavity.

“This case shows that regular health check-ups and timely examination when there are unusual signs are extremely important. When there are unusual symptoms such as drooping eyelids, chest pain, difficulty breathing, prolonged cough... people need to go to a medical facility with specialized expertise to get early diagnosis and timely treatment, avoiding unpredictable complications,” Dr. CKII Than Trong Vu advised.

Hai Chau

Source: https://doanhnghiepvn.vn/tin-tuc/phau-thuat-thanh-cong-khoi-u-vo-bao-than-kinh-hiem-gap/20250926102406394