Surgical management of atypically located thoracic schwannomas: a single-center case series

Schwannomas are benign nerve sheath tumors most commonly located in the posterior mediastinum. However, atypically located thoracic schwannomas are rare and may pose challenges in diagnosis and surgical management. In this retrospective case series, 14 patients who underwent surgical treatment for atypically located thoracic schwannomas between 2011 and 2025 were evaluated. Demographic, clinical, radiological, surgical, and histopathological data were analyzed. The associations between tumor location and clinical or surgical variables were assessed using Fisher’s exact test and the Chi-square test. The mean age of the patients was 51.4 years (range: 24–77), with a predominance of male cases. Tumor locations were classified as supraclavicular (n = 4), anterior/middle mediastinum (n = 4), infraclavicular (n = 2), chest wall (n = 3), and lung parenchyma (n = 1). Pain was the most common presenting symptom. All patients underwent curative (R0) surgical resection. Surgical approaches included VATS (n = 4), RATS (n = 1), thoracotomy (n = 3), and modified open techniques (n = 6). No statistically significant association was found between tumor location and complication rates, surgical method, or length of hospital stay. No recurrences were observed during a mean follow-up period of 48 months. Although rare, atypically located thoracic schwannomas should be considered in the differential diagnosis of intrathoracic masses. With accurate preoperative imaging and proper surgical planning, these lesions can be safely and completely resected, resulting in favorable clinical outcomes.