ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Multiple intercostal nerve sheath cysts located at costovertebral angle in bilateral hemithorax
Tevfik İlker Akçam1, Ayşe Gül Ergönül1, Önder Kavurmacı2, Kutsal Turhan1
1Department of Thoracic Surgery, Ege University School of Medicine, Izmir, Turkey
2Department of Thoracic Surgery, Bozyaka Training and Research Hospital, Izmir, Turkey
DOI : 10.5606/tgkdc.dergisi.2019.16859

Neurogenic tumors arising from nerve tissues may be located on the posterior mediastinum.[1,2] This study presents the case of an asymptomatic male patient who presented with multiple bilateral mediastinal lesions of different sizes that were radiologically similar to neurogenic tumors. After a histopathological examination, the lesions were identified as "edematous nerve tissue".

A 41-year-old asymptomatic male patient was evaluated by computed tomography prior to an appendectomy, revealing multiple bilateral, paravertebral, and uniformly limited lesions (Figure 1-d). The largest lesion was 3.4¥2.2 cm and all lesions were found to have a cystic structure in magnetic resonance imaging (Figure 1e) and to be non-metabolic in positron emission tomography. Multiple cystic lesions, ranging in size from 1 cm to 4 cm and located at the 3-7 costal vertebral angles were detected on video-assisted thoracoscopic exploration of the right hemithorax (Figure 1f). Cyst fluid was aspirated and lesions with diameters of 3-cm and 4-cm were fully excised. Thoracic drainage was terminated on the third day and the patient was discharged. A histopathological examination revealed the cyst fluid to be benign, and the cysts, which were fully excised, were composed of edematous nerve tissue.

Figure 1: (a-d) Different computed tomographic images of the lesions. (e) Magnetic resonance imaging section. (f) Peroperative view.

Declaration of conflicting interests
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Funding
The authors received no financial support for the research and/or authorship of this article.