A RARE NERVOUS TUMOR : THE MEDIASTINAL SCHWANNOMA ( ABOUT ONE CASE)
Hasna Jabri, Respiratory Diseases Department, Loubna Najah, Wiam Elkhattabi, Hicham Afif, Hospital 20 Août 1953, CHU Ibn Rochd Faculty of medicine of Casablanca University Hassan II of Casablanca., Respiratory Diseases Department; Hospital 20 Août 1953; CHU Ibn Rochd Faculty of medicine of Casablanca University Hassan II of Casablanca., Respiratory Diseases Department; Hospital 20 Août 1953; CHU Ibn Rochd Faculty of medicine of Casablanca University Hassan II of Casablanca., Respiratory Diseases Department; Hospital 20 Août 1953; CHU Ibn Rochd Faculty of medicine of Casablanca University Hassan II of Casablanca.
2018
International Journal of Advanced Research
Schwannoma is rare nervous tumors developed at the expense of the nervous girdles of myalinated nerves fibers. They can be discovered in a fortuitous way or be responsible for médiastinal syndrome by compression of the organs of neighborhood. These hurts put diagnostic difficulties due to their deep location and require in the majority of the cases an appeal to a diagnostic surgery. Case report: We report the case of a 58-year-old patient, without pathological histories or toxic habits. He
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... nted badly right thoracic pains, radiating in paralateral breastbone with a dyspnea in the effort for 1 month. The clinical examination was normal. Having eliminated a cardiological urgency, a radiography of thorax objectified an opacity with hilar projection and over the right hilum of médiastinal look ( Figure1). The thoracic scanner showed a mass of tissular density sitting at the level of the posterior médiastin centered by hypodense zones of 51×38×27mm (Figure2). For a better anatomical approach of the mass, the thoracic magnetic resonance imaging (MRI) objectified a heterogeneous process posterior médiastinal in a paralateral gutters arriving at the contact of the vertebral arc without a lysis of the born and without invasion of the spinal canal. He is for the contact of the downward aorta without invading it. This process is hétérosignal in T1 and T2 raising, in a hétèrogène way after injection of the gadoliminium ( Figure 3 ). After meeting of multidisciplinary dialogue, the patient was operated. The right video-assisted thoracotomy surgery allowed the resection of a mass of 70×35×30 mm 36 g member the lung. suites operating comment were simple. The histological study revealed a tumour fusiform cells on encapsulated proliferation. These cells expressed in a intense way the protein S100 without expression of the actine develop the muscle of ribband and the CD34. The set was in favour of a thoracic schwannome. No complementary care was proposed except a simple supervision. Discussion:- Schwannoma is rare benign tumor of neurogenic origin developed at the expense of the nervous myélinated girdles. At the thoracic level, they represent approximately 75 % of the tumors of the nervous envelopes and arise most of the time at young patient's from 20 to 50 years old with a feminine ascendancy [1]. They are located most of the time at the level of the intercostal nervous roots situated in laterovertebral gutters [2] . Their extension can be intrathecal by the spinal foramens in approximately 5 % of the cases [3] . They show themselves frequently by intercostal and brachial neuralgias, as with our patient, but are most of the time of fortuitous discovery on simple
doi:10.21474/ijar01/7761
fatcat:sydl76dfg5a2hn3djkcrgzqzq4
