Spinal Schwannoma With Intrathoracic Extension: Successful En Bloc Resection via Uniportal Video-Assisted Thoracoscopic Surgery (VATS)

Schwannomas are benign, well-encapsulated tumors arising from Schwann cells, which are responsible for the myelination of peripheral and central nerves. This report highlights a rare incidence of a T4 thoracic schwannoma with right paraspinal extension into the thoracic cavity. A 77-year-old woman presented with bilateral lower limb weakness; MRI revealed a T3-T5 intradural extramedullary lesion extending from the spinal canal into the right posterior mediastinum. A multidisciplinary surgical approach was employed: the neurosurgical team first performed a posterior laminectomy to resect the intraspinal component, followed by en bloc resection of the intrathoracic tumor via uniportal video-assisted thoracoscopic surgery (VATS) by the cardiothoracic team. This combined approach enabled complete tumor excision and favorable neurological recovery, highlighting the importance of coordinated multidisciplinary management in complex thoracic schwannomas with intraspinal extension.