• Yang Yue, Hua Xin, Bao-Cen Xu, Le-Ning Zhang, and Wei Zhao.
• Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin.
• Medicine (Baltimore). 2019 Jul 1; 98 (30): e16582.

RationaleThe presence of a mediastinal neurilemmoma accompanied by intrapulmonary sequestration is a rare occurrence. The clinical symptoms of a neurilemmoma depend on the site of the tumor. Diagnosis of pulmonary sequestration mainly depends on the presence of aberrant feeding arteries.Patient ConcernsA 78-year-old woman was admitted to our hospital with a mediastinal space-occupying lesion of 50 years. Computed tomography and magnetic resonance imaging showed 2 roundish low-density shadows in the left posterior mediastinum.DiagnosisThe pathological findings of the upper cystic mass support the diagnosis of neurilemmoma. A branch of aorta was found supplying blood to the lower mass; it was considered a pulmonary sequestration.InterventionsLeft-sided thoracotomy was planned to remove the chest space-occupying lesions. Two masses were completely removed. Severe adhesion between the left lower lobe and the diaphragm was successfully separated, the aberrant feeding vessel was properly managed, and the lower lobe was resected completely.OutcomesThe patient experienced remission of symptoms, had no significant postoperative complications, and was discharged from the hospital.LessonsSpecial attention should be paid to neurological involvement of the neurilemmoma and the fragile feeding arteries of the intrapulmonary sequestration. Early diagnosis and treatment are important in such cases.

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