Surgical treatment of mediastinal cysts: report on 29 cases

Mediastinal cysts are rare, forming 12-18% of all primary mediastinal tumors. The purpose of this study is to evaluate type, clinical properties, treatment modalities, and results of mediastinal cystic neoplasm in the light of available literature.

We retrospectively investigated 29 patients who were diagnosed and surgically treated for mediastinal cysts in our clinic between January 1996 and May 2011.

Sixteen (55.2%) patients were male and 13 (44.8%) were female. The average age of the patients was 36.5 +/- 22.1 (17-77 years old). The mediastinal cysts comprised 11 (37.9%) bronchogenic cysts; seven (24.1%) hydatid cysts; four (13.8%) benign cystic teratomas; three (10.3%) pericardial cysts; one (5.3%) thymic cyst; one (5.3%) cyst of the thoracic duct; one (5.3%) enteric cyst; and one (5.3%) lymphangioma. Approach methods were thoracotomy in 18 (62.1%) cases; video-assisted thoracoscopicsurgery (VATS) in seven (24.1%) cases; median sternotomy in three (10.3%) cases; and anterior mediastinotomy in one case. Postoperative observations during the follow-up period showed chylothorax in one patient; pleural effusion in one patient; and the recurrence of a bronchogenic cyst in one patient five years after the operation. Postoperative mortality did not occur in any case. The average postoperative hospitalization period was 7.3 days (2-14 days).

A surgical approach to mediastinal cysts offers histological analysis, pathological diagnosis, curative treatment, and prevention from complications.