• Journal of Chest Surgery
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• v.23 no.2
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• pp.325-332
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• 1990

Complications of the mediastinal tumors and cysts are malignant change, infection, bleeding, local invasion and mass effect to heart, lung and other mediastinal structures. But early surgical excision and proper treatments bring patients to good clinical course and results. Therefore mediastinal tumors and cysts are surgically interesting diseases We report the analysis of the 58 cases of mediastinal tumors and cysts, experienced in the Department of Cardiothoracic Surgery of the Kosin Medical College from July 1979 to June 1989. The results were as follows ; Sex ratio of male to female to female was 1.3: 1. Range of age was from 11 to 64 years and mean age was 34.3 years. The thymomas were 14 cases[24%], the teratomas were 19 cases[33%o], the neurogenic tumors were 10 cases[17%], the cysts were 9 cases[15%], the carcinomas were 3 cases[5%], the thyroid tumor was 1 case[2%], the Castleman’s disease was 1 case[2%] and unclassified tumor was 1 case[2%]. Malignant tumors were 12 cases [21%] of the 58 cases. Most frequent symptom was chest pain and discomfort and relationship of symptom and malignancy was significant. Complete removal of tumor was performed on the 47 cases[92%] and partial excision was 3 cases[6%]. Inoperable cases were treated with anticancer chemotherapy and radiotherapy. Postoperative complications were wound infection, Homer’s syndrome, phrenic nerve palsy, mediastinal hematoma and pleurisy. There was no case of postoperative mortality and good clinical course in surgically completely resected cases.

• Journal of Chest Surgery
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• v.21 no.4
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• pp.681-691
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• 1988

Fifty-five patients with primary mediastinal tumors and cysts which were seen at T.S. Dept., HYUH, were analyzed clinically, histologically, in an incidence of anatomic location and therapeutic results. The results were summarized as follows; 1] The ages of the patients in this series ranged from 15 months to 79 years with the highest incidence in the age group of third decade, and there were no sex distribution[M:F=0.96]. 2] The most frequently encountered tumors were teratodermoid tumors[29%] followed by neurogenic tumors[22%], thymomas[15%] and benign cysts[11%] in decreasing order of frequency. 3] Based on the subdivision of the mediastinum, 62% of the tumors were in the antero-superior mediastinum, 7% in the middle mediastinum and 31% in the posterior mediastinum. 4] The most frequent symptom was chest pain and others were dyspnea, cough, chest tightness and dysphagia. Asymptomatic patients were 29%. 5] Benign tumors and cysts were 71% and malignant tumors were 29%. 6] The successful removal was possible in all the benign mediastinal tumors and cysts[39 cases] and partial removal or biopsy was performed in the 12 cases among 16 cases of malignant mediastinal tumors. 7] Postoperative complications were bleeding, chylothorax, vocal cord paralysis, wound infection and hypothyroidism. 8] The most frequent mediastinal tumor in the West is neurogenic tumor but is teratoma in Korea.

• Journal of Chest Surgery
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• v.28 no.10
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• pp.917-923
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• 1995

For the purpose of analysis of clinical and pathological characteristics in mediastinal tumors and cysts, 82 patients with mediastinal tumors and cysts treated in the department of thoracic and cardiovascular surgery in Chosun University Hospital during the period from January 1978 to December 1994 were reviewed. There were 49 male and 33 female patients in the study. Age ranges from 10 months to 84 years, with the mean 37.2 years. Frequently encountered symptoms and signs were dyspnea[40.2% , abnormal breathing sound[37.8% , chest pain[35.7% , cough[26.8% , and 18.2% of patients were asymptomatic. The most frequent tumor was anterosuperior mediastinum [59.8% followed by middle[24.4% and posterior mediastinum[15.8% . The malignant tumors were found in 35 cases[42.7% . Successful removal of the mass was possible in all the benign mediastinal masses[57.3% . But in the malignant cases, the surgical removal was possible in 18 cases and other inoperable cases were treated by radiation and chemotherapy. The postoperative complications occurred in 9 cases. Usual complications were bleeding[4 cases , wound infection[3 cases , pneumothorax[1 case and vocal cord paralysis[1 case . In the pathologic viewpoint, teratodermoid tumors[22.0% were the most frequent tumor followed by thymomas[19.5 , benign cysts[15.8% , lymphomas[13.4% and neurogenic tumors[8.5% .

• Journal of Chest Surgery
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• v.44 no.4
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• pp.279-284
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• 2011

Background: The aim of this study is to investigate the clinical characteristics and management of intrathoracic bronchogenic cysts. Materials and Methods: Twenty-four (n=24) patients with intrathoracic bronchogenic cysts were treated surgically between August 1990 and December 2009 at our institution. Patients were divided into two groups by bronchogenic cyst location: mediastinal or intrapulmonary. Symptoms at diagnosis, radiologic findings, locations, surgical methods, pathological findings, and surgical outcomes were investigated retrospectively from consecutive patient medical records. Results: There were 12 females (50.0%). The mean age was 26.8 (range, 5 to 64) years. The mean follow-up period was 27.3 (range, 1 to 121) months. There were 15 (62.5%) mediastinal and 9 (37.5%) intrapulmonary bronchogenic cysts. Symptoms occurred in 8 patients with mediastinal bronchogenic cysts (53.3%) and 5 patients with intrapulmonary bronchogenic cysts (55.6%) (p=1.000). On computed tomography (CT), 7 patients (46.7%) showed homogenous solid masses in mediastinal bronchogenic cysts and five (55.6%) patients exhibited heterogeneous cystic masses with air-fluid levels in intrapulmonary bronchogenic cystic masses. Open thoracotomy was performed in 17 (70.8%) patients, and video-assisted thoracic surgery was performed in 7 (29.2%) patients. On pathological findings, there were 16 (66.7%) complicated cysts, and in 13 symptomatic patients, 11 (84.6%) patients had complicated cysts. There was no operative death in this study. During the follow-up period, no recurrence was detected. Conclusion: Intrathoracic bronchogenic cysts have a wide variety of clinical characteristics and radiologic findings. Even though some patients do not experience symptoms and signs caused by bronchogenic cysts, serious symptoms and complications may develop with the passage of time.

• Journal of Chest Surgery
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• v.24 no.3
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• pp.245-252
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• 1991

For the purpose of evaluation of clinical characteristics and histopathological properties in mediastinal tumors and cysts, 50 patients with mediastinal tumors and cysts treated at the department of thoracic and cardiovascular surgery in Chosun University Hospital during the period from January, 1978 to Mach, 1990 were reviewed. The results of this cases analysis were as follows; 1. of all 50 mediastinal tumors and cysts, 27 patients were male and 23 patients were female. There was no sex preference. The age distribution was from 10 months to 84 years, and mean age was 37 years old, and no age preference. 2. Subjective symptoms were as follows : Dyspnea[54%], Chest pain[44%], Coughing [34%] Fever[16%] and General malaise[12%]. Objective signs were as follows: Decreased breathing sound[46%], Pleural effusion and hemothorax[32%], Palpable neck mass[24%] and SVC syndrome[14%]. But, there were no definitive symptoms in 5 cases[10%]. 3. The most frequently encountered tumors were teratodermoid tumors[26%] followed by lymphomas[22%], thymomas[12%] and benign cysts[8%] in decreasing order of frequency. 4. Based on the subdivision of the mediastinum, 44% of the tumors were in the anterior mediastinum, 24% in the middle mediastinum, 18% in the superior mediastinum and 14% in the posterior mediastinum. 5. The malignant tumors were 25 cases[50%]. 6. The successful removal was possible in all the benign mediastinal tumors and cysts. In malignant cases, the surgical removal had been 12 cases and inoperable cases were treated to radiation and chemotherapy. 7. Postoperative complications were bleeding, wound infection, pneumothorax and vocal cord paralysis. The recurrence was 3 cases. 8. The most frequent mediastinal tumor in the west is neurogenic tumor but is teratoma in Korea.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.849-854
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• 1985

We have experienced 50 cases of mediastinal tumors and cysts from March, 1979 to August, 1985 at Kyung Hee University Hospital. The results of this cases analysis were as followings; 1. Of all 50 mediastinal tumors and cysts, 26 patients were male and 24 patients were female. There was no sex preference. The age distribution was from 27 months to 64 years, and mean age was 33.5 years old, and also no age preference. 2. The most common mediastinal tumor was benign cysts [12 cases], which comprise 24% of all mediastinal tumors and cysts. The second common mediastinal tumor was teratoma [9 cases-18%], and followed by thymic tumors and tuberculous granuloma [7 cases-14% each], neurogenic tumors [5 cases-10%], and other tumors [10 cases-20%]. 3. The anterior mediastinum was most common tumor location, and followed by middle, superior, and posterior. 4. All 9 teratomas were developed at anterior mediastinum, and 4 of 5 neurogenic tumors were developed at posterior mediastinum. Thymomas were developed at anterior and superior mediastinum. The bronchogenic cysts had no predilection of location. 5. The most common chief complaint at admission was chest pain or discomfort [23 cases-46%], and followed by cough with or without sputum, and exertional dyspnea. Asymptomatic patients were only 7 patients [24%]. 6. Of all 50 cases, 38 cases [76%] received radical tumor resection, 7 mediastinoscopic biopsy, 3 explo thoracotomy and biopsy, and 1 neck mass biopsy. 7. There were 2 hospital deaths, one of which was a patient who suffered malignant thymoma and Myasthenia Gravis. The patient received radical tumor excision, but died at 7th POD. The other patient was a patient with malignant transformation of the benign cystic teratoma. The operative mortality was 4%.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.299-308
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• 1990

A review of 50 patients with primary mediastinal tumors or cysts has been done to evaluate clinical and pathological behavior of this heterogeneous group of tumors proved by either excision or biopsy from January 1980 to August 1989 at the cardiovascular department of surgery in Kyungpook National University Hospital. There were 30 males and 20 females in this series. The ages of patients ranged from 4 months to 64 years. The mean age of subjects was 30.4 years. Neurogenic tumors [14 cases, 28%] and teratoma [14 cases, 28%] were most frequently encountered and followed by thymoma [10 cases, 20%] and benign cysts [4 cases, 8%]. The anatomic location of the primary mediastinal tumors or cysts was classified as anterior mediastinum and middle or visceral mediastinum and paravertebral or costovertebral mediastinum on the basis of the Shields’ proposition. In 32 patients[64%], the tumors or cysts were located in anterior mediastinum and in 13 patients[26%], the tumors or cysts were located in paravertebral or costovertebral mediastinum. And the rest 5 patients[10%] had middle or visceral mediastinal tumors or cysts. One of the characteristic features of primary mediastinal tumors or cysts is that some mediastinal tumors or cysts have their own preferred location in the mediastinum. In our series, all of the 14 patients with teratoma and 10 patients with thymoma had the anterior mediastinal location, while 13 of the 14 patients with neurogenic tumors had the paravertebral mediastinal location. 14 patients[28%] were asymptomatic and they all were discovered via so-called “Routine” chest x-ray examination. 39 of 50 patients[78%] were benign. 11 patients[22%] were malignant and they were all symptomatic. 40 patients[80%] were treated with complete resection. 5 patients[10%] were treated with partial resection : 2 of malignant thymoma, 3 of lipoma, neuroblastoma, primary squamous cell carcinoma. The rest 5 patients[10%] were only biopsied: 2 of undetermined malignancy and 3 of hemangioma, lymphoma, primary squamous cell carcinoma. 4 of the 10 patients were treated with combination of irradiation and chemotherapy. Postoperative complications were as followings: Horner’s syndrome [4cases, ado], respiratory failure [3 cases, 6%], pleural effusion[3 cases, 6%], Wound infection[2 cases, 4%] and bleeding, pneumothorax, empyema. There were 5 postoperative deaths [10%]. One patient with neuroblastoma died from intraoperative massive bleeding, 3 patients died early postoperatively from respiratory failure with undetermined malignancy died late postoperatively from congestive heart failure due to direct invasion of the tumor to the heart.

• Journal of Chest Surgery
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• v.21 no.5
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• pp.863-870
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• 1988

Many varieties of space-occupying lesions can occur in the mediastinum. During the twenty-three-year period 1966-1988, we had experienced the 151 cases of primary mediastinal tumors and cysts at the Thoracic k Cardiovascular Dept., CUMC. The most common histologic types were thymomas and germ cell tumors, followed by neurogenic tumors and lymphomas. Most non-neoplastic lesions were granulomatous lesions and cysts. The mediastinal tumors were often asymptomatic, the malignant tumors in 35.4%, the benign tumors and cysts in 72.8% of the cases. The most common symptom was pain, which occurred in one-fourth of the patients. The most useful diagnostic method was X-ray examination of the chest. However, a final diagnosis could usually be made only at operation. Nine malignant tumors[30.0%] were excised radically, 17[56.7%] palliatively and 4[13.3%] were only biopsied. Almost all benign tumors except tuberculous lymphadenitis were radically excised. Fourteen patients received postoperative radiation therapy and 17 received chemotherapy. The postoperative complications were developed in 15[11.7%] and hospital mortality was 0.8%.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.745-749
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• 1990

A wide variety of histologically or clinically different tumors and cysts can occur from the many anatomical structures located within the mediastinum. We report the analysis of the 26 cases of mediastinal tumors and cysts, experienced in the Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hallym University from March 1983 to February 1990. Sex ratio of male to female was 1:1.16 and mean age was 33.4 years. Malignant tumors were 8 cases[30.7%], benign tumors were 18 cases[69.2%] The most common histologic types were thymoma, 6 cases[23%] and teratoma, 6 cases [23%] followed by neurogenic tumor, 4 cases[15%] and mediastinal tuberculoma, 3 cases [11.5%]. The most frequent symptoms were chest pain and discomfort. Most of benign tumors were completely removed and malignant tumors were treated with anticancer chemotherapy and radiotherapy after operation. Postoperative complications were developed in 4 cases[15.3%] and hospital mortality was 3.8%.

• Journal of Chest Surgery
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• v.24 no.8
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• pp.773-781
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• 1991

We have experienced 47 cases of primary mediastinal tumors & cysts in the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital, from September, 1979 to November, 1990. The results were as follows: 1. The age distribution was from 6 months to 69 years old and the mean age was 32.3 years old. Of all 47 primary mediastinal tumors and cysts, 21 patients were male and 26 patients were female. 2. The neurogenic tumors[11 cases, 23.4%] were most frequently encountered and followed by thymoma[10 cases. 21.3%] and teratodermoid[9 cases, 19.1%]. 3. The anterosuperior mediastinum[59.6%] was most common tumor location, and followed by posterior mediastinum[25.6%], middle mediastinum[14.9%]. 4. The most common tumors were thymoma and teratodermoid at anterosuperior mediastinum, benign cyst at middle mediastinum, and neurogenic tumor at posterior mediastinum 5. The malignant tumors were 10 cases[21.3%] of the 47 cases and they were all symptomatic. 6. The most common chief complaint at admission was chest pain or discomfort[34%], and followed by coughing[23.4%], and dyspnea[17%]. 7. The successful complete removal was done in 37cases of benign tumors and cysts. In malignant cases, the surgical intervention was done in 3 cases, and 6 cases were treated with irradiation and chemotherapy, and 1 case was only biopsied. 8. The postoperative complications were developed in 7 cases[14.6%]. There was no case of hospital mortality.