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Diagnosis and Treatment of Primary Mediastinal Tumors and Cysts - Forty-two years report in a University Hospital -  

Park, Moo Suk (Department of Internal Medicine, Yonsei University College of Medicine)
Chung, Kyung Young (Department of Cardiovascular and Thoracic Surgery, Yonsei University College of Medicine)
Kim, Kil Dong (Department of Cardiovascular and Thoracic Surgery, Yonsei University College of Medicine)
Lee, Hong Lyeol (Department of Internal Medicine, Inha University College of Medicine)
Chung, Jae Ho (Department of Internal Medicine, Yonsei University College of Medicine)
Hahn, Chang Hoon (Department of Internal Medicine, Yonsei University College of Medicine)
Moon, Jin Wook (Department of Internal Medicine, Yonsei University College of Medicine)
Kim, Young Sam (Department of Internal Medicine, Yonsei University College of Medicine)
Shin, Dong Hwan (Department of Pathology, Yonsei University College of Medicine)
Kim, Se Kyu (Department of Internal Medicine, Yonsei University College of Medicine)
Kim, Hyung Joong (Department of Internal Medicine, Yonsei University College of Medicine)
Chang, Joon (Department of Internal Medicine, Yonsei University College of Medicine)
Ahn, Chul Min (Department of Internal Medicine, Yonsei University College of Medicine)
Kim, Sung Kyu (Department of Internal Medicine, Yonsei University College of Medicine)
Publication Information
Tuberculosis and Respiratory Diseases / v.56, no.1, 2004 , pp. 29-39 More about this Journal
Abstract
Background : The diagnostic and therapeutic approaches to mediastinal tumors and cysts have changed over the past three decades. This report summarizes our forty-two years of experience with these tumors. Methods : This study retrospectively reviewed 479 patients with primary mediastinal tumors and cysts that were diagnosed and managed over the past 17-year period (1985~2002) and compared them to the report of the previous 25-year result (1960~1985) in Yonsei University College of Medicine, Severance Hospital in Seoul, Korea. Results : During the 17 years, there were 479 cases of pathologically proven mediastinal tumors and cysts. Thymoma (38.2%) was the most common mediastinal tumor and has increased noticeably during recent years. The gender ratio showed a male predominance (1.3:1) and the age distributions were even over all the age groups. The most common sites of the tumor and the proportion(28.6%) of malignant tumors were the same as that previously reported. A diagnosis of a tumor in asymptomatic patients was possible in 174 cases (36.3%), which was higher that reported previously. The diagnostic yield of a fine needle aspiration biopsy was 68.6% in the total tumors and 80.9% in the malignant tumors. A surgical resection was the most frequently chosen treatment modality and was performed in 405 cases (84.6%). The complete resection rate was 91.1%, which is higher than the previous result of 78.8%. Conclusion : These results showed that the prevalence of mediastinal tumors and cysts, particularly thymoma, increased. A fine needle aspiration biopsy was a valuable preoperative differential diagnostic method for malignant tumors. The surgical and complete resection rate increased remarkably possibly due to the better applicable chest CT scans, the more frequent health check-up provided by the regular health promotion program for all people as a health insurance policy, and the improved diagnostic techniques in the pathologic, radiological, and clinical fields.
Keywords
Mediastinal tumors; Cysts; Diagnosis; Treatment;
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