Anterior cervical approach for resection of brachial plexus schwannoma expanding into the thoracic apex

Primary tumors of the brachial plexus are unusual. We describe 2 patients with schwannomas of the brachial plexus that had the radiologic appearance of apical lung masses. We used anterior cervical approach for both of the patients. Our technique permitted safe and complete resection of the tumors of this complex area. Both tumors were arising from the Th1 component of brachial plexus. Histopathological findings revealed that both of the tumors were benign schwannomas. This approach is quick and safe, allowing much better control of the important vascular and neural structures of the thoracic apex. Tumors at the area are inaccessible by using posterolateral thoracotomy or video-assisted thoracic surgery. We suggest that the anterior cervical approach would be applied for the resection of other kind of tumors in the thoracic apex.