Posterior Mediastinal Schwannoma with Subclavian Artery Thrombosis

Schwannomas are most common posterior mediastinal tumors. They are usually asymptomatic. Due to the indolent nature of the tumor, Schwannomas have the potential to grow large and encase and invade important anatomical surrounding structures. A middle-aged lady presented with features of ischemic changes of left upper limb and on evaluation Schwannoma arising from inter-vertebral foramen of second thoracic vertebra, causing compression of left subclavian artery with resultant thrombosis of the artery. Excision of the tumor by left postero-lateral thoracotomy along with thrombo-embolectomy of left subclavian artery was done. Schwannoma and other posterior mediastinal tumor may also be considered as a differential diagnosis while evaluating the causes of thrombosis of subclavian artery and gangrene of upper limb. Early diagnosis and timely management can prevent unnecessary amputation of the limb.