Rationale: Posterior mediastinal schwannomas near the intervertebral foramen pose surgical challenges owing to their proximity to critical neurovascular structures. Patient concerns: A 19-year-old woman presented with an abnormal shadow on a chest radiograph obtained during a routine health checkup. Diagnoses: Magnetic resonance imaging revealed a 3.5-cm mass in the right paravertebral region at the T3–T4 level, suggestive of schwannoma. Interventions: The tumor was resected via 4-port robot-assisted thoracic surgery. Intraoperatively, the intercostal nerve was found to traverse the tumor and was divided. Arista AH was used to control oozing near the intervertebral foramen. Outcomes: The patient recovered uneventfully and was discharged on postoperative day 8. Pathological examination confirmed schwannoma. She has remained recurrence-free for 12 months. Lessons: Robot-assisted thoracic surgery enables safe resection of tumors adjacent to the intervertebral foramen. Arista™ AH may provide effective hemostasis in anatomically sensitive areas.
Tando et al. (2026) studied this question.