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Vol. 45. Issue 8.
Pages 371-375 (August 2009)
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Vol. 45. Issue 8.
Pages 371-375 (August 2009)
Original article
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Benign Primary Cystic Lesions of Mediastinum in Adult: The Clinical Spectrum and Surgical Treatment
Lesiones quísticas primarias y benignas del mediastino en el adulto: espectro clínico y tratamiento quirúrgico
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Soner Gürsoya,
Corresponding author
grssoner@gmail.com

Corresponding author.
, Ata Ozturka, Ahmet Ucveta, Ahmet Emin Erbaycub
a Department of Thoracic Surgery, Suat Seren Chest Disease and Thoracic Surgery Training Hospital, Izmir, Turkey
b Department of Chest Diseases, Suat Seren Chest Disease and Thoracic Surgery Training Hospital, Izmir, Turkey
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Abstract
Background and objective

The mediastinal cysts form a group of heterogeneous and uncommon benign lesions of neoplastic, congenital, or inflammatory conditions. The forgoing controversy is how to manage them; surgical removal or observation. We reviewed our experience including some rare conditions, emphasizing the clinical spectrum and surgical treatment.

Patientes and methods

This is a retrospective review between 2000 and 2007 included 34 cases of primary mediastinal cystic lesions. Clinical features, imaging techniques, surgical operation, morbidity, mortality and follow-up were analyzed.

Results

There were 18 females (53%) and 16 males (47%), with a mean age±standard deviation of 45.3±14.1 years (range: 22-74). Most of cysts were congenital (94%), except patients with hydatid disease (6%). 24% of cysts (n=8) were detected in anterior mediastinum. Rest of them (n=26) were located in visceral mediastinum. Patients usually were symptomatic (61%). Chest pain and discomfort was most common symptom, others were dyspnea, cough and hemoptysis, respectively. Cysts excision was performed in all cases with an uneventful recovery and with no recurrence in long term follow up.

Conclusions

Asymptomatic mediastinal cysts are not rare. Surgery is a reliable method of treatment of mediastinal cysts with acceptable mortality and morbidity.

Keywords:
Mediastinal cysts
Mediastinum
Surgery
Thoracotomy
Congenital
Resumen
Introducción

Los quistes mediastínicos forman un grupo de lesiones benignas heterogéneas y poco comunes de naturaleza neoplásica, congénita e inflamatoria. Continúa la controversia sobre cómo tratarlos, ya sea mediante extracción quirúrgica u observación. Examinamos nuestra experiencia en este campo, que incluye algunas situaciones infrecuentes, haciendo hincapié en el espectro clínico y el tratamiento quirúrgico.

Pacientes y métodos

Se ha realizado un estudio retrospectivo de 34 pacientes atendidos entre 2000 y 2007 por lesiones quísticas primarias del mediastino. Se analizaron las características clínicas, las técnicas de imagen empleadas, el tipo de cirugía, la morbilidad, la mortalidad y el seguimiento.

Resultados

El grupo estuvo constituido por 18 mujeres (53%) y 16 varones (47%), con una media de edad (±desviación estándar) de 45,3±14,1 años (rango: 22-74). La mayoría de los quistes eran congénitos (94%), excepto en los pacientes con enfermedad hidatídica (6%). El 24% de los quistes (n=8) se detectó en el mediastino anterior y el resto (n=26) se localizó en el mediastino visceral. La mayoría de los pacientes (61%) presentaba síntomas. El dolor y el malestar torácicos fueron los síntomas más frecuentes, seguidos de la disnea, la tos y la hemoptisis. En todos los casos se procedió a la escisión del quiste, con la recuperación sin incidentes de los pacientes y sin recurrencias en el seguimiento a largo plazo.

Conclusiones

Los quistes mediastínicos asintomáticos no son infrecuentes. La cirugía es un tratamiento seguro para los quistes mediastínicos, con una mortalidad y morbilidad aceptables.

Palabras clave:
Quistes mediastínicos
Mediastino
Cirugía
Toracotomía
Congénito
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Copyright © 2009. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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