• Journal of Chest Surgery
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• 제21권5호
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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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• 제18권4호
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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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• 제23권4호
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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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• 제27권4호
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• pp.297-302
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• 1994

This report is a review of 98 cases of the primary mediastinal tumors which are treated in the Department of Thoracic and Cardiovascular Surgery, Chonnam University Hospital from January, 1985 to February, 1993 and divided two groups. One group is from January, 1985 to January, 1989 and named it Group 1[G1]. Another group is from February, 1989 to February, 1993 and named it Group 2[G2]. Chest pain is the most common clinical manifestation in the two groups. The common mediastinal tumors are teratoma 11 cases[29.7%], neurogenic tumor 7 cases[18.9%], thymoma 6 cases[16.2%], primary cyst 3 cases[8.1%] in Group 1 and thymoma 16 cases[26.2%], teratoma 15 cases[24.6%], neurogenic tumor 9 cases[14.8%], primary cyst 9 cases[14.8%] in Group 2. Therefore this result shows that the incidence of thymoma is increased in group 2. In benign tumors, the subjective symptoms are 64.3% in group 1 and 63.6% in group 2. In malignant tumors, they are 100% in group 1 and 82.4% in group 2. this result shows that asymptomatic malignant tumors are increased in group 2. The successful excision is done in all of the 71 benign tumors except one. In malignant tumors, the complete surgical excision is increased from 11.1% in group 1 to 41.2% in group 2.

• Journal of Chest Surgery
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• 제1권1호
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• pp.37-44
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• 1968

This paper is a review of 29 cases of mediastinal tumors originating in the mediastinum or metastasized from other organs and classified on the basis of histopathological types and specific anatomic location in this depart-ment, during nine years period from January 1959 to December 1967. In twenty-three cases, diagnosis was confirmed by histological findings and the rest of the cases were considered to be mediastinal tumors by clinical and/or roentgenological findings. In this series, metastatic mediastinal carcinomas of unknown primary site were most frequent [30.4%] and lymphoma ranked second in frequency comprising 21.7% of total. Range of age was 5 to 61 years and average mean age was 39 years old. Sex ratio was 1.4 male to female. Subjective complaints in order of frequency were as follows: dyspnea [37%], cough [34%], chest pain[24%] and chest discomfort [21%]. Objective signs were as follows: hoarseness [17%], palpable cervical lymph node[17%], blood tinged sputum [10%], weight loss [10%] and superior vena cava syndrome [7%]. There was no operative mortality. There were histologically nine different kinds of mediasfinal tumors in this series.

• Journal of Chest Surgery
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• 제23권2호
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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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• 제12권4호
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• pp.424-428
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• 1979

Clinical observation were performed on 25 cases of Mediastinal tumors or Cyst, those were admitted and treated at the Department of Thoracic and Cardiovascular Surgery, Korea University Hospital, during the 6 years period from March 1973 to March 1979. The following results are obtained. Of 25 cases, 19 patients were males and 6 patients were females. Range of age varied widely from 2 years to 72 years. Approximately 28% were younger than 15 years of age at the time of diagnosis. The common subjective symptoms of the patients were anterior chest pain [36%], coughing [27%], dyspnea and a few incidence of hemoptysis. Diagnostic procedures were posteroanterior and lateral chest roentgenorgrams, Chest tomograms, Brochograms, Esophagograms, Mediastinoscopy, Scalene and Axillary Lymph node biopsy, and Needle aspiration biopsy. In the histological distribution on Mediastinal tumors in order of frequency, Neurogenic tumor 6 cases [25%], Lymphoma 5 cases [21%], Bronchogenic cyst 4 cases [17%], Pericardial cyst 2 cases [8.3%], Teratodermoid tumor 2 cases [8.3%], and each one case of Rhabdomyosarcoma, Seminoma, Cavernous hemangioma, Anthracosis, Tuberculoma were noted respectively. Of 24 cases of the histologically confirmed Mediastinal tumors, 6 cases [24%] were malignant. Thoracotomy for removal of tumor or cyst was performed on 17 cases and offered cure of all benign tumors. In 6 cases of malignant tumors, Chemotherapy with Vincristine, Cyclophosphamide and Prednisolone was given to 1 case Lymphoma. There was no case of postoperative mortality.

• Journal of Chest Surgery
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• 제18권4호
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• pp.881-885
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• 1985

This report is an analysis of 183 cases of mediastinal tumors which were experienced in the Department of Thoracic and Cardiovascular Surgery, Yonsei Medical Center from January 1960 to June 1985. In this series, teratoma and neurogenic tumors were found to be the most frequent tumors [24.0%] histopathologically. Male to female sex distribution was 1.2 to 1 with the male predominant. The main clinical symptom was dyspnea, and there was no definitive symptom in 10.9% of all cases. In operating, all of the benign tumors were removed. The most frequent complication was wound infection. [13.7%].

• Journal of Chest Surgery
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• 제55권2호
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• pp.174-176
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• 2022

Mediastinal paragangliomas are rare tumors that have only been reported in individual cases or limited case series. Surgical resection of these tumors can be challenging, as they are highly vascular and intimately related to the great vessels. Surgery is usually performed via median sternotomy with or without cardiopulmonary bypass. We present the case of a mediastinal paraganglioma that was resected via a left-sided posterolateral thoracotomy. Histopathology revealed a completely resected 38-mm paraganglioma with a positive station 5 lymph node, indicative of locally aggressive disease. Hereditary paragangliomas are associated with malignant transformation; therefore, genetic testing is important. These tumors do not respond well to chemoradiotherapy, and consequently lifelong surveillance for early detection of recurrence is recommended.

• Tuberculosis and Respiratory Diseases
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• 제40권5호
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• pp.575-583
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• 1993

연구배경 : 종격동 종양 및 낭종은 매년 100,000명당 1예의 빈도로 발생하는데 반수 정도에서 증상없이 우연히 발견되기도 하고 흉강내에서 인접한 주위 조직들을 압박하거나 침범함으로써 증상을 유발하기도 한다. 종격동 종양은 모든 연령층에서, 그리고 남녀간에 뚜렷한 차이 없이 고르게 발생하고 해부학적 구역에 따라 호발하는 종양이 다르며 양성 종양이라고 하더라도 가능한 초기에 적극적으로 절제하는 것이 권장되는 임상적인 특징을 보인다. 방법 : 연세대학교 의과대학 세브란스병원에서 1960년 1월부터 1992년 8월까지 병리조직학적으로 원발성 종격동 종양 및 낭종으로 확진된 344예를 대상으로 하여 발생 빈도와 발생 연령, 그리고 성별에 따른 빈도를 조사하였다. 그리고 진단 당시에 환자들이 주로 호소하였던 임상증상, 무증상의 빈도, 악성의 발생 빈도 및 치료 방법 등의 임상적인 양상들을 살펴보았다. 결과 : 전체 종격동 종양중 신경성 종양이 24.7%로 가장 많았고 기형유피종과 흉선종이 각 29.1%로 두번째로 많았다. 연령별 분포에서는 10세 미만에서 가장 적은 반면 나머지 연령층에서는 비교적 균등한 분포를 보였으며 전체적인 남녀 성비가 1.1:1로써 종격동 종양에서 남녀간의 차이는 유의하지 않은 것으로 관찰되었다. 신경성 종양은 후종격동에, 기형유피종과 임파종은 전종격동에, 그리고 흉선종은 전종격동에 호발하였으며 전체적으로 전부(52.0%)에서 가장 많이 관찰되었다. 내원 당시 환자들이 가장 많이 호소한 증상은 호흡곤란(27.7%)이었고 흉부 X-선상 종격동 종양이 우연히 발견될 때까지 전혀 증상이 없었던 경우가 19.5%를 차지하였다. 신경성 종양의 경우 27.1%, 기형유피종은 13.0%, 그리고 흉선종은 40.6%에서 악성의 양상을 보였으며 전체적으로 34.0%가 악성이었다. 대상 환자 344예중 42.4%에서 완전 또는 부분 절제가 시행되었고 13.6%에서 항암 화학요법이나 방사선 치료가 시행되었으며 43.9%는 조직 생검만이 시행되었는데 후자의 경우는 거의 대부분 1985년 이전의 경우이었다. 절제가 시행되었던 146예중 34예(23.3%)에서 수술후 30일 이내에 합병증이 발생하였는데 창상 감염이 6예로 가장 많았으며 농흉이 5예의 순이었고 여러 가지 신경의 손상은 12예 있었다. 결론 : 종격동 종양은 최근 빈도가 증가할 뿐만 아니라 치료에 있어 적극적인 절제의 경향을 보인다. 향후 정기적인 건강 검진의 보급 및 진단 수기의 발달로 더 많은 종격동 종양이 진단되리라고 기대되며 이로써 우리나라에서의 특징적인 임상 양상에 대한 연구가 필요하겠다.