CTICasesGiant Benign Schwannoma of the Thorax
Imaging findings
Chest radiograph shows complete opacification of the right hemithorax with contralateral displacement of the mediastinal structures. Contrast-enhanced CT reveals a massive, heterogeneous chest mass with central necrotic areas and focal calcification, causing severe compression of the mediastinum and narrowing of the adjacent trachea and main bronchi.
Key takeaways
Schwannomas are benign, slow-growing nerve sheath tumors that usually arise from spinal nerve roots or intercostal nerves in the posterior mediastinum. When they grow to an extremely large size, they can occupy the entire hemithorax, mimicking malignant pleural or parenchymal neoplasms. Despite their giant size, calcification, and necrotic appearance, these tumors are typically histologically benign and can be treated successfully with surgical resection, often requiring a large approach like a clamshell incision.
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