Preoperative irradiation of selected mediastinal masses

During a 17-year period from 1982 to 1999, 117 patients underwent surgical treatment of mediastinal masses. Resection was accomplished in the majority (81 or 69%) of these masses; with the remaining patients (36 or 31%) having biopsy procedures only. Malignant tumors were found in 43 patients (37%). A small subset of the biopsy group (4 patients or 11%) with symptomatic anterior masses were assessed to be of high risk for significant complications of anesthesia during the biopsy procedure and were treated with a short course of preoperative radiation to the mass prior to operation. All patients were operated upon without complication and definitive pathologic diagnosis was made in all cases despite preoperative low dose irradiation to the area of biopsy. Our experience demonstrates a practical and effective way of dealing with a potentially disastrous situation without compromising the accuracy of diagnosis.