Diagnosis, treatment, and management of mediastinal masses

Mediastinal neoplasms are relatively rare tumors that require surgical or non-surgical treatment, and they harbor a wide variety of cell types. The aim of this study was to evaluate the surgical outcomes and prognosis of patients who underwent surgery for mediastinal masses.

The age, gender, symptoms, comorbid factors, radiological findings, preoperative diagnostic steps, surgical procedure, mortality, complications, length of hospital stay, histopathological diagnosis, and survival of 118 patients with mediastinal masses operated on for diagnosis and treatment between January 2013 and December 2018 were retrospectively analyzed.

When the mediastinal masses were evaluated according to compartments, the most common mass was found in the anterior mediastinum (n=72, 61%). While 83.3% of malignant lesions were located in the anterior mediastinum, no malignant lesion was detected in the posterior mediastinum. There was a significant correlation between the compartment where the mass was located and its malignancy. A significant increase in the malignancy rate was observed among male patients. The likelihood of malignancy increased with increasing tumor size (p=0.002). Complications were shown to significantly extend the length of hospitalization (p=0.018). Overall survival was found to be at an average of 71.46±2.1 months. The 5-year survival rate was found to be 88.1%. There was a significant difference in survival between genders, in favor of the female sex (p=0.02).

Considering the low morbidity and mortality rates of mediastinal masses, surgical intervention should be performed promptly for the diagnosis and treatment of mediastinal masses. With videothoracoscopy, adequate biopsies can be obtained from unresectable masses and complete excision of benign lesions can be achieved safely.