PMC4560149_01
Preoperative findings. a Coronal view of chest computed tomography (CT). A tumor involved 3.5 cm of the left tracheal wall, protruding inside and outside the tracheal wall. b Bronchoscopy showing a submucosal tumor affecting four tracheal cartilaginous rings
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Fig1
CT showed a tumor involving 3.5 cm of the left tracheal wall and protruding inside and outside the tracheal wall (Fig. 1a). Bronchoscopy verified a submucosal tumor affecting four tracheal cartilaginous rings (Fig. 1b).
Intraoperative findings. a Intraoperative picture. A yellowish soft tumor with multinodularity stretched along the left recurrent nerve (white asterisk) and infiltrated the tracheal and esophageal wall (yellow asterisk) to a greater extent than estimated. T trachea, N left recurrence laryngeal nerve, BA brachiocephalic artery. b Schema of the tumor
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Fig2
Surgical exploration revealed a yellowish, soft, multinodular tumor stretching along the left recurrent nerve and infiltrating the tracheal and esophageal walls (Fig. 2a, b). We confirmed small nodules on the cranial side of tracheal wall apart from the main tumor, which were also diagnosed as schwannoma (Fig. 2b).
Pathological findings. a Macroscopic specimen of the resected tumors. b Hematoxylin and eosin stain (x100). There were spindle cells shown in a palisaded fashion. It was a typical finding of Antoni A schwannoma with no malignancy
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Fig3
As it was impossible to achieve complete resection, we determined to preserve the trachea and resect the tumor nodules to the greatest extent possible (Fig. 3a). The pathological features were identical to those of typical schwannomas, including being composed solely of Schwann cells frequently disposed in a compact, palisaded fashion (Antoni A) (Fig. 3b) and occasionally in a loose texture (Antoni B).