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

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.