CC BY 4.0 · Surg J (N Y) 2016; 02(02): e46-e50
DOI: 10.1055/s-0036-1584519
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Giant Benign Mediastinal Masses Extending into the Pleural Cavity

Güven Sadi Sunam
1   Department of Thoracic Surgery, Medical Faculty, Selçuk University, Konya, Turkey
,
Murat Öncel
1   Department of Thoracic Surgery, Medical Faculty, Selçuk University, Konya, Turkey
,
Sami Ceran
2   Department of Thoracic Surgery, Medical Faculty, Necmettin Erbakan University, Konya, Turkey
,
Kemal Ödev
3   Department of Radiodiagnostics, Medical Faculty, Necmettin Erbakan University, Konya, Turkey
,
Hüseyin Yıldıran
1   Department of Thoracic Surgery, Medical Faculty, Selçuk University, Konya, Turkey
› Author Affiliations
Further Information

Publication History

20 March 2016

16 May 2016

Publication Date:
10 June 2016 (online)

Abstract

Introduction The aim of the study was to evaluate the results of surgery to remove huge mediastinal masses and their pathology. Surgical resection was chosen for accurate diagnosis and treatment of the huge mediastinal masses extending into the pleural cavity.

Methods Records were reviewed for eight patients who had the diagnosis of huge benign mediastinal masses and who underwent operation; details of the patients and operations were recorded.

Results Mean age was 34.5 (range 22 to 44) years, and male-to-female ratio was 2:6. Computed tomography and magnetic resonance imaging (MRI) were used to evaluate the location and extent of the abnormality and to characterize the tissue components of the mass. Most of the tumors were located in the posterior mediastinum. The most frequent presenting symptom was exertional dyspnea. The majority of cases underwent posterolateral thoracotomy, and complete resection was possible in seven patients. Partial resection could only be performed in one. The mean diameter of the resected masses was 15 × 10 cm. Histopathologic examination revealed 3 neurogenic tumors, 2 teratomas, 1 thymolipoma, and 1 ectopic thyroid, and 1 hemangioma. Minor complication was seen in two cases.

Conclusion The presurgical thoracic MRI provided correct diagnosis along with radiologic characterization and topography. Surgery must be the preferred treatment in huge benign mediastinal masses.

 
  • References

  • 1 Kanemitsu Y, Nakayama H, Asamura H, Kondo H, Tsuchiya R, Naruke T. Clinical features and management of bronchogenic cysts: report of 17 cases. Surg Today 1999; 29 (11) 1201-1205
  • 2 Strollo DC, Rosado-de-Christenson ML, Jett JR. Primary mediastinal tumors: part II. Tumors of the middle and posterior mediastinum. Chest 1997; 112 (05) 1344-1357
  • 3 Balcı AE, Eren Ş, Eren N. Erişkinlerde mediastenin primer tümör ve kistleri; 61 olgunun klinik değerlendirmesi ve cerrahi sonuçları. Turkiye Klinikleri J Med Sci 2003; 23: 33-37
  • 4 Cohen AJ, Thompson L, Edwards FH, Bellamy RF. Primary cysts and tumors of the mediastinum. Ann Thorac Surg 1991; 51 (03) 378-384 , discussion 385–386
  • 5 Davis Jr RD, Oldham Jr HN, Sabiston Jr DC. Primary cysts and neoplasms of the mediastinum: recent changes in clinical presentation, methods of diagnosis, management, and results. Ann Thorac Surg 1987; 44 (03) 229-237
  • 6 Davis RD, Oldham HN, Sabiston DC. The mediastinum. In: Sabiston and Spencer Surgery of the Chest. 6th ed. Vol. 1. Philadelphia, PA: W.B. Saunders Company; 1996: 576-611
  • 7 Hoffman OA, Gillespie DJ, Aughenbaugh GL, Brown LR. Primary mediastinal neoplasms (other than thymoma). Mayo Clin Proc 1993; 68 (09) 880-891
  • 8 Strollo DC, Rosado de Christenson ML, Jett JR. Primary mediastinal tumors. Part 1: tumors of the anterior mediastinum. Chest 1997; 112 (02) 511-522
  • 9 Lewis BD, Hurt RD, Payne WS, Farrow GM, Knapp RH, Muhm JR. Benign teratomas of the mediastinum. J Thorac Cardiovasc Surg 1983; 86 (05) 727-731
  • 10 Rendina EA, Venuta F, Ceroni L. , et al. Computed tomographic staging of anterior mediastinal neoplasms. Thorax 1988; 43 (06) 441-445
  • 11 Trastek VF. Management of mediastinal tumors. Ann Thorac Surg 1987; 44 (03) 227-228
  • 12 Bacha EA, Chapelier AR, Macchiarini P, Fadel E, Dartevelle PG. Surgery for invasive primary mediastinal tumors. Ann Thorac Surg 1998; 66 (01) 234-239
  • 13 Cakan A, Yuncu G, Olgac G. , et al. Retrospective evaluation of 53 cases with primary mediastinal tumors and cysts. Turk J Thorac Cardiovasc Surg 2001; 9: 101-104
  • 14 Sarper A, Gurkok S, Ozuslu BA, Genc O, Balkanlı K. Primary mediastinal masses: analysis of the 64 cases. Turk J Thorac Cardiovasc Surg 2001; 9: 153-155
  • 15 Demirkaya A, Kaynak K. Mediastinal cysts. Turkiye Klinikleri J Surg Med Sci 2006; 2 (47) 23-26