• Journal of Chest Surgery
• /
• v.36 no.1
• /
• pp.59-62
• /
• 2003

Mediastinal parathyroid cyst is a very rare disease and is usually found incidentally. Surgical excision is the treatment of choice and recurrence is very rare when complete excision is done. A 71-year-old man was referred to our department because of 6$\times$5cm sized right superior mediastinal mass found incidentally on chest X-ray Surgical excision was performed and pathologic findings were confirmed as mediastinal parathyroid cyst. The patient has been followed up postoperatively without recurrence for 4 months up to now. We report a case of mediastinal parathyroid cyst.

• Journal of Chest Surgery
• /
• v.42 no.6
• /
• pp.781-784
• /
• 2009

Pericardial cyst is an uncommon congenital mediastinal tumor. The majority of pericardial cysts are located in the right cardiophrenic angle, but rarely they can be located intrapericardially. We now present a case of a huge intra-pericardial pericardial cyst excised with video-assisted thoracoscopic surgery.

• Journal of Chest Surgery
• /
• v.31 no.1
• /
• pp.40-45
• /
• 1998

Recently, video-assisted thoracoscopic surgery for mediastinal lesions has been considered a new effective therapeutic method. From March, 1992 to April, 1997, 33 cases of video assisted thoracoscopic surgery for mediastinal lesions were performed. Gender distribution was 16 males and 17 females. Average age was 42 years old(ranged from 14 to 69). The locations of lesions were anterior mediastinum in 14 cases, middle mediastinum in 5 cases, posterior mediastinum in 11 cases, and superior mediastinum in 3 cases. These included 9 neurilemmomas, 5 benign cystic teratoma, 4 pericardial cysts, 2 ganglioneuroma, 2 thymus, 2 thymic cyst, 1 thymoma, 2 esophageal leiomyomas, 1 dermoid cyst, 1 lipoma, 1 malignant lymphoma, 1 bronchogenic cyst, 1 pericardial effusion, and 1 Boerhaave's disease with empyema. Working window was needed in 6 cases. We converted to open thoracotomy in 6 cases. Reasons of convertion to open thoracotomy were large sized mass(1), severe adhesion(3), and difficult location to approach(2). The average operation time was 116min($\pm$56 min). The average chest tube drainage time was 4.7days. The average hospital stay was 8.7 days. Operative complications were atelectasis(2), empyema with mediastinitis(1), recurrent laryngeal nerve palsy(1), and plenic nerve palsy(1). In conclusion, VATS for mediastinal lesions were performed with shorter operation time and hospital stay, and lesser complications and pain than those of conventional thoracotomy.

• Journal of Chest Surgery
• /
• v.30 no.11
• /
• pp.1149-1153
• /
• 1997

Unilateral reexpansion pulmonary edema(RPE) is generally considered a rare complication occurring when a chronically atelectatic lung is rapidly reexpanded by tube thoracostomy or thoracentesis. It can also take place when the lung collapse is of short duration or when the lung is reexpanded without intrapleural sucti n. We experienced a case of RPE following surgical resection in mediastinal thymic cyst A 26 year old female patient suffered from long-standing atelectasis of the right lung due to a huge mediastinal cyst that was misrecognized as tuberculous pleural effusion. Empyema developed after iatrogenic rupture of mediastinal cyst by pig-tailed tube thoracostomy. We successfally managed the ruptured mediastinal thymic cyst, empyema and postoperatively developed RPE following reexpansion of the collapsed lung. The patient was treated with drugs and mechanical ventilation with positive end-expiratory pressure for RPE. The remainder of her hospital course was uneventful.

• Journal of Chest Surgery
• /
• v.39 no.8 s.265
• /
• pp.655-658
• /
• 2006

Mesothelial cyst is a rare mediastinal tumor and usually presents in the right cardiophrenic angle. However, it sometimes occurs in atypical locations and it’s locating in the posterior mediastinum, especially, is very rare. A large cystic mass of the posterior mediastinum between pericardium and vertebral body was incidentally recognized in a patient of a 30-year-old woman admitted due to traffic accident. Even though it was very large in size measuring 18 em at longest diameter and is extending mainly to the left pleural cavity, she had no symptomatic complaints. Complete excision was performed through video-assisted thoracoscopic surgery with a additional small working window, which was necessary for dissecting the deepest point to the right pleural cavity. She is in good condition without recurrence on long-term follow-up.

• Tuberculosis and Respiratory Diseases
• /
• v.53 no.4
• /
• pp.439-444
• /
• 2002

We report a very rare case of mediastinal tuberculosis in a 57-year old woman who presented with a large mediastinal cyst on chest radiography. She had a 10-year history of exertional dyspnea, but felt comfortable at a rest. A subsequent chest CT suggested a mediastinal cyst with mediastinal lymphadenopathy and communicating pericardial sac. She underwent a thoracotomy and excision of the mass, which was histologically revealed to be of tuberculous origin. Although rare, the apparent increase in the incidence of tuberculosis may result mediastinal cysts being diagnosed mediastinal tuberculosis. We also briefly review mediastinal lymphadenopathy due to tuberculosis.

• Journal of Chest Surgery
• /
• v.29 no.7
• /
• pp.763-768
• /
• 1996

This report is an analysis of 43 cases of primary mediastinal tumors and cysts which were treated in the Department of Thoracic and Cardiovascular Surgery, Tae Jeon Eul li General Hospital from January, 1986 to April, 1995. There were 19 males and 24 females, and their ages ranged from 4 years to 68 years, with mean age of 31.3 years. The most common symptoms were dyspnea 48.8%, chest disconyort 39.5%, cough )4.9%, and chest pain 23.3%, and the most frequently encountered location of tumor was anterior mediastinum followed by posterior, and middle mediastinum. From the pathologic viewpoint, teratoma was the most frequent type followed by neurogenic tumors, cysts, thymoma, and Iymphoma. The most useful diagnostic method was plain X-ray examination of the chest, and final diagnosis could usually be made only after an operation. All of benign tumors were completely removed and malignant tumors were treated with chemotherapy and radiotherapy after operation There were 7 (16.3 %) cases of postoperative complications, and there was no postoperative mortality.

• Journal of Chest Surgery
• /
• v.40 no.6 s.275
• /
• pp.459-462
• /
• 2007

Pericardial cysts are uncommon benign congenital mediastinal lesions and they are most often found in either cardiophrenic angle. We present here one case of atypically located pericardial cyst that was located in the sub-pulmonary region. The clinicians should take into consideration this entity in the differential diagnosis of cystic lesion of the mediastinum. The diagnostic difficulties that are encountered and the utility of video-assisted thoracoscopy are described.

• Journal of Chest Surgery
• /
• v.35 no.11
• /
• pp.807-811
• /
• 2002

Due to its less invasive nature and superior visual field, video-assisted thoracescopic excision of mediastinal mass is thought to be comparable to open thoracotomy. Material and Method : From January 1995 to August 2001, the medical records of 38 patients who underwent video-assisted thoracoscopic excision of mediastinal mass was retrospectively analyzed. The outcome of these patients were compared with 5 patients who converted to thoracotomy Result: Male to female ratio was 13(34.2%) : 25(65.8%), and mean age was 39.2$\pm$35.4 years. Regarding the pathology, there were 8 neurilemmomas(21.1%), 6 thymic cysts (15.8%), 5 teratomas(13.2%), 5 ganglioneuromas(13.2%), 4 bronchogenic cysts(10.5%), 3 pericardial cysts(7.9%), 3 thymomas(7.9%), and 2 lymphangiomas(5.3%). The mean operation time was 110.6$\pm$7.0 minutes, mean postoperative tube stay was 4.2$\pm$0.4 days, mean postoperative hospital stay was 5.2$\pm$0.4 days, and mean number of injection of analgesics was 1.9$\pm$0.4 times. Although the mean values for the above indices were less than those of the thoracotomy conversion cases, they were statistically insignificant. Postoperative complications of videoassisted thoracoscopic excision included chylothorax, prolonged air leakage, and unilateral phrenic nerve palsy, all of which recovered before patient discharge. There was, however, permanent unilateral ptosis in one patient. Conclusion : As video-assisted thoracoscopic excision of mediastinal mass is safe, less painful, conducive to earlier recovery and cosmetically more appealing, a more active application of this technique is recommeded.

• Journal of Chest Surgery
• /
• v.31 no.10
• /
• pp.1017-1021
• /
• 1998

Mesothelial cysts have many other names, such as pericardial celomic cyst, pleura- diaphragmatic cyst, simple cyst of the mediastinum, springwater cyst, serosal cyst, etc. (Petereit 1972, Drash 1950). Most mesothelial cysts are believed to originate from malformations of the pericardium, but some, like the one in this case, are believed to result from a pleural malformation. (Ochsner 1966, Lambert 1940). Mesothelial cysts are extremely rare and can be confirmed histologically by special stains. A 64 year old woman was admitted due to a painless bulging mass in her right neck. The operation was performed with the initial diagnosis of cystic lymphangioma confirmed by computer tomography and total excision was possible. The diagnosis of mesothelial cyst of the mediastinum was confirmed by histologic examinations (stainings) and the patient was discharged from the hospital without any significant complications.