A CASE OF A LOCALLY INVASIVE INTRA-THORACIC SCHWANNOMA

TOPIC: Disorders of the Mediastinum TYPE: Medical Student/Resident Case Reports INTRODUCTION: A schwannoma is a rare neurogenic tumor arising from cells that form nerve sheath. They make up quarter all tumors and are seen between 20 to 50 years age. typically have an asymptomatic presentation benign course, with malignant features in around 5% cases. We present case 74-year-old female incidentally discovered intercostal presenting chronic back pain. CASE PRESENTATION: history pain syncope was worked for coronary artery disease due multiple risk factors. She underwent CT calcium scanning which had minimal calcification but found 3 cm x 2.5 mass at right azygoesophageal recess erosion into adjacent vertebra. It confirmed be spindle cell neoplasm on biopsy S-100 positivity immunohistochemical staining, consistent schwannoma. Further, MRI revealed paravertebral contrast-enhancing measuring approximately 5.1 3.0 3.7 lateral T8 vertebral body as well 8th posterior medial rib. After discussion patient, she robot-assisted resection tumor. The postoperative course uncomplicated resolution her follow-up. DISCUSSION: Schwann arise neural crest during embryonic development, ectodermal derivative responsible giving rise peripheral nervous system. As result, most mediastinal mediastinum along spinal roots. But they might chest wall nerves, anterior mediastinum, or lung parenchyma. Neurogenic account just 12% tumors, being common among them. These noted incidental findings imaging. Though majority schwannomas presentation, may mimic lesions. About 16% patients symptoms like observations correspond our well, patient mild non-specific scan. Though, contrast-enhanced scan ideal investigations assess extent size mass, instances screening tests provide important information nonspecific atypical Additionally, CT-guided symptomatic incongruent imaging help differentiate CONCLUSIONS: Intercostal usually symptoms. seldom locally invasive REFERENCE #1: SAVU C, GRIGORIE V, MELINTE A, DIACONU ILIESCU L, DIMITRIU M et al. Giant Intrathoracic Schwannoma: Report. In Vivo. 2020;34(6):3527-3532. #2: Kransdorf M. Malignant soft-tissue large referral population: distribution diagnoses by age, sex, location. American Journal Roentgenology. 1995;164(1):129-134. #3: Demirag F, Yazicioglu Aydogdu K, Kaya S, Karaoglanoglu N, Bicakcioglu P. Tumors. Thoracic Cardiovascular Surgeon. 2013;62(02):147-152. DISCLOSURES: No relevant relationships APURV AGARWAL, source=Web Response Viral Desai, Henry Sadlo,