Primary tumors of the mediastinum: 190 cases analysis (1975-1995)

A series of 190 patients with primary mediastinal tumors have been reviewed, typing of the tumors is according to pathological findings. The most common type of primary mediastinal tumors in this study was tumors of germ cell origin which comprised 38.9 per cent of total cases. Most patients were adults with a median age of 33.1 years and male to female ratio was 1.24:1. The characteristic of each type of tumor has been discussed. The common presenting symptoms were dyspnea, chest pain, and coughing, hemoptysis may occur in some cases. Only 7.9 per cent of cases were asymptomatic and all were discovered during the so-called "routine" chest X-ray examination. The diagnosis can be reached by the radiographic finding of mediastinal shadows. Bronchoscopy is commonly valuable to confirm external compression of the trachea and bronchi as well as revealing the invasion of the mediastinal tumors into the bronchial lumen. Pathological findings of the tissue sections obtained from fine needle aspiration or biopsy, as well as surgical specimen can provide the definite diagnosis and classification of the tumors. The benign tumors were successfully removed by surgery. As some types of malignant tumors are either chemosensitive or radiosensitive; chemotherapy and/or radiotherapy carries a potential survival benefit and should be incorporated into the multimodality approach to prolong disease-free survival.