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Case Reports in Surgery
Volume 2015, Article ID 175645, 3 pages
http://dx.doi.org/10.1155/2015/175645
Case Report

An Unusual Presentation of a Posterior Mediastinal Schwannoma Associated with Traumatic Hemothorax

Department of Surgery, Division of Trauma and Surgical Critical Care, The Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA

Received 4 March 2015; Revised 16 April 2015; Accepted 24 April 2015

Academic Editor: Shin-ichi Kosugi

Copyright © 2015 Ruchi Amin and Brett H. Waibel. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Schwannomas of the thoracic cavity are typically an asymptomatic, benign neurogenic neoplasm of the posterior mediastinum. In this case, we present a traumatic hemothorax as the initial presentation for a previously undiscovered mediastinal mass. The patient presented with shortness of breath and right-sided chest pain after being struck in the chest with a soccer ball. An operative exploration was pursued due to persistent hemothorax with hemodynamic instability despite resuscitation and adequate thoracostomy tube placement. The intraoperative etiology of bleeding was discovered to be traumatic fracture of a large hypervascular posterior mediastinal schwannoma. Surgical resection is the treatment of choice for these tumors. Specific serological markers do not exist for this tumor, and radiographic findings can be variable, so tissue diagnosis is of importance in differentiating benign from malignant schwannomas, as well as other posterior mediastinal tumors. However, most patients have excellent survival following complete resection.