Clamshell Thoracotomy: A Unique Approach to a Massive Intrathoracic Schwannoma

Schwannomas (neurilemmomas) are benign tumors arising from the Schwann cells of the neural sheath. They are typically well-encapsulated lesions and in the chest they are most commonly seen within the posterior mediastinum, often originating along the intercostal nerves. Several operative approaches have previously been described for the resection of these tumors, including thoracoscopic techniques and posterolateral thoracotomy. We report a case of a massive schwannoma (27 cm, maximum diameter), unresectable by described approaches, which was successfully excised using a clamshell thoracotomy.