Bilateral mediastinal neurofibroma of the vagus nerves in a patient with neurofibromatosis type 1

Ann Thorac Cardiovasc Surg. 2013;19(4):293-6. doi: 10.5761/atcs.cr.12.01937. Epub 2012 Nov 17.

Abstract

Bilateral mediastinal vagus neurogenic tumors are very rare. We herein report the case of Neurofibromatosis type 1 (NF-1) patient with bilateral neurofibromas originating from the mediastinal vagus just distal site of the recurrent nerve, who underwent two-staged extirpations that successfully preserved both recurrent nerves. A 31-year-old female with a history of NF-1 was admitted to our hospital under a diagnosis of multiple tumors in the upper mediastinum. First, the tumor at the right paratracheal to precarinal site was completely resected through a median sternotomy, preserving the right recurrent nerve. After confirming no right recurrent nerve paralysis, thoracoscopic resection of the tumor at the aorto-pulmonary window was then performed preserving the left recurrent nerve. The histopathological diagnosis was neurofibroma originating from the bilateral mediastinal vagus nerves. A two-staged operation can be an option in cases with bilateral mediastinal vagus nerve tumors to avoid the risk of bilateral recurrent nerve paralysis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biopsy
  • Cranial Nerve Neoplasms / pathology
  • Cranial Nerve Neoplasms / surgery*
  • Female
  • Humans
  • Mediastinal Neoplasms / pathology
  • Mediastinal Neoplasms / surgery*
  • Neurofibromatosis 1 / pathology
  • Neurofibromatosis 1 / surgery*
  • Recurrent Laryngeal Nerve Injuries / etiology
  • Recurrent Laryngeal Nerve Injuries / prevention & control
  • Sternotomy*
  • Thoracoscopy*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vagotomy*
  • Vagus Nerve / pathology
  • Vagus Nerve / surgery*
  • Vagus Nerve Diseases / pathology
  • Vagus Nerve Diseases / surgery*
  • Vocal Cord Paralysis / etiology
  • Vocal Cord Paralysis / prevention & control