CTICasesVagal Schwannoma
Imaging findings
CT chest shows a large, shaggy, middle mediastinal mass with cystic elements, causing severe mass effect and compression of the left atrium. Pathology post-resection confirmed a benign schwannoma arising from the vagus nerve.
Key takeaways
Schwannomas are benign nerve sheath tumors that can arise in the mediastinum. While typically posterior mediastinal (arising from intercostal nerves or sympathetic chains), they can arise in the middle mediastinum from the vagus or phrenic nerves. Large schwannomas can exhibit shaggy cystic degeneration and necrosis, mimicking aggressive middle mediastinal sarcomas or duplication cysts.
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