İntratorasik Yerleşimli Schwannoma Patolojik Tanılı Hastaların Analizi, Tek Merkez Deneyimi

Amaç: Nörilemmoma schwan hücrelerinden köken alan, nörojenik tümörler içerisinde en sık görülen alt gruptur. Sıklıkla 3.-5. dekadlarda saptanır.Genellikle posterior mediyasten yerleşimlidir. Cerrahi olarak rezeke edildiğinde nüks görülme oranları çok düşüktür. Bu çalışmada kliniğimizde rezekeedilen bu tip tümörlerin analizi yapılıp, literatür eşliğinde değerlendirildi.Gereç ve Yöntem: Ankara Üniversitesi Tıp Fakültesi Göğüs Cerrahisi Anabilim Dalı’nda Ocak 2008 - Ocak 2018 tarihleri arasında rezeke edilenschwannoma tanısı alan 25 hasta retrospektif olarak incelendi. Preoperatif tüm hastalar toraks bilgisayarlı tomografi ile değerlendirildi. Spinalkanala invazyon şüphesi olma durumunda magnetik rezonans görüntüleme sistemi kullanıldı.Bulgular: Çalışmaya alınan tüm hastaların 14’ü (%56) erkek, 11’i (%44) kadın idi. Yaş ortalaması: 47±12,6 (31-66) idi. Hastaların genelinde baskınsemptom sırt ağrısı idi. Lezyonların sıklıkla paravertebral sulkusta yerleşim gösterdiği saptandı. Schwannoma kitlelerinin %56’sı sağ, %44’ü solhemitoraksta izlendi. Rezeksiyon için 18 hastaya kas koruyucu torakotomi, altı hastaya video yardımlı torakoskopik cerrahi, bir hastaya medyansternotomi prosedürü uygulandı.Sonuç: Nöral hücrelerden köken alan nörojenik tümörlerin en sık görülen tipi Schwan hücrelerinden köken alan nörilemmoma’lardır. Genellikleposterior mediyasten yerleşimlidir. Oran olarak %40-60 arası asemptomatik seyrederler. Bizim hastalarımızda semptomlu hastaların oranı dahayüksekti. Schwannomalarda rezeksiyon uygulanan hastalarda nüks olma ihtimali çok düşüktür.

Analysis of Patients with Intrathoracic Placement Schwannoma Pathological Diagnosis, Single Center Experience

Objectives: The origin of neurilemmoma is Schwann cells and it is the most frequent subgroup of neurogenic tumors. It is often detected in the 3rd-5th decades. The region is located in the posterior mediastinum. Recurrence rates are very low when surgically resected. In this study, this type of tumor resected in our clinic was analyzed and evaluated with the literature. Materials and Methods: Twenty-five patients diagnosed with Schwannoma resected between January 2008 and January 2018 in Ankara University Faculty of Medicine, Department of Thoracic Surgery were retrospectively reviewed. All preoperative patients were evaluated by thoracic computed tomography. In case of suspicion of invasion into the spinal canal, magnetic resonance imaging was used. Results: Of all the patients included in the study, 14 (56%) were male and 11 (44%) were female. The mean age was 47±12.6 (31-66) years. The main symptom in the patients was back pain. It was determined that the lesions were frequently located in the paravertebral sulcus. 56% of Schwannoma masses were observed in the right and 44% in the left hemithorax. For resection, 18 patients underwent muscle sparing thoracotomy, six patients underwent video-assisted thoracoscopic surgery, and one patient underwent a median sternotomy procedure. Conclusion: The most common type of neurogenic tumors originating from neural cells is neurilemmomas originating from Schwann cells. It is generally located in the posterior mediastinum. They are asymptomatic between the rates of 40% and 60%. In our patients, the rate of symptomatic patients was higher. Recurrence is very low in patients undergoing resection in Schwannoma.

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