Journal of the Chinese Medical Association
Volume 69, Issue 1 , Pages 37-41, January 2006

Intrathoracic Paraspinal Malignant Peripheral Nerve Sheath Tumor

  • Ruay-Sheng Lai

      Affiliations

    • Division of Chest Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr. Ruay-Sheng Lai, Division of Chest Medicine, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan, R.O.C.
    • ,
  • Shong-Ling Lin

      Affiliations

    • Department of Pathology, Kaohsiung Veterans General Hospital, Kaohsiung, Taipei, Taiwan, R.O.C.
    • ,
  • Shu-Shong Hsu

      Affiliations

    • Division of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taipei, Taiwan, R.O.C.
    • ,
  • Min-Ting Wu

      Affiliations

    • Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Received 15 March 2005; accepted 4 August 2005.

Article Outline

Schwannoma is the most common nerve sheath tumor in the posterior mediastinum, whereas intrathoracic paraspinal malignant peripheral nerve sheath tumor (MPNST) is quite rare. Both benign and malignant nerve sheath tumors may be symptomatic, rendering clinical differentiation of limited utility. On radiographic imaging, erosion of the ribs and vertebral bodies, irregularity in contour, and inhomogeneity in attenuation are not sufficiently reliable for diagnosis of MPNST. Histologically, MPNSTs reveal hypercellularity, nuclear atypia, and mitotic activity. Surgical resection is the main modality of treatment. Postoperative radiation therapy for MPNST has led to a significant reduction in local recurrence. The prognosis is unfavorable. Herein, we present an unusual case of a posterior mediastinal mass in a 50-year-old female with delayed diagnosis of 2 years. After surgical intervention, the histologic finding was MPNST. Postoperative radiation therapy was applied because of incomplete resection. The follow-up chest computed tomography 5 months later revealed a residual soft tissue mass with significant reduction in size over the parathoracic spine area. No neurologic sequelae were identified after surgery.

Key Words:  malignant peripheral nerve sheath tumor , neurogenic tumor , posterior mediastinal tumor

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PII: S1726-4901(09)70109-1

doi:10.1016/S1726-4901(09)70109-1

Journal of the Chinese Medical Association
Volume 69, Issue 1 , Pages 37-41, January 2006

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