Schwannoma presenting as an apical thoracic tumour with upper extremity symptoms

SUMMARY. The case of an apical tumour in the thorax, which presented with upper extremity symptoms, is reported. Surgery was performed and a diagnosis was established of a neurogenic mediastinal tumour, a schwannoma, compressing the T1 nerve root. This case illustrates the need for the thoracic surgeon to consider a brachial plexus or upper thoracic nerve root tumour when evaluating a patient with neurological upper extremity symptoms. Adequate preoperative evaluation is essential in such cases to enable the thoracic surgeon to select the best surgical approach, sometimes aided by a neurosurgical team. Emphasis is placed on the difficulties faced by the surgeon when exposing a tumour complicated by its localization in the superior mediastinum and which is anatomically linked with delicate nerve fascicles. Pneumon 2010, 23(4):380-383.