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Presentation of primary mediastinal masses in Ibadan
V O Adegboye1, A O Ogunseyinde, M O Obajimi
1Department of Surgery, University College Hospital, PMB 5116, Ibadan, Nigeria.
Insights
This study on primary mediastinal masses in a Black African population found most patients are symptomatic, with asymptomatic cases more often benign. Lymphoma was the most common type, frequently located in the anterosuperior mediastinum.
Area of Science:
- Thoracic surgery
- Oncology
- Pathology
Background:
- Primary mediastinal masses are rare and diverse.
- Understanding their epidemiology in specific populations is crucial for diagnosis and treatment.
Purpose of the Study:
- To characterize the clinical features, anatomical distribution, and histological subtypes of primary mediastinal masses.
- To analyze these characteristics within a Black African demographic.
Main Methods:
- A retrospective analysis of 105 patients diagnosed and treated between 1975 and 1999.
- Data collected from patient records, cardiothoracic, and pathology departments.
- Radiological evaluation and tissue biopsies were performed; masses categorized by mediastinal location (anterosuperior, middle, posterior).
Main Results:
- The most common masses were lymphoma (21.9%), thymus tumors (18.1%), and endocrine tumors (17.1%).
- The anterosuperior mediastinum was the most frequent location (63.8%).
- While most patients (77.1%) were symptomatic, absence of symptoms was significantly more associated with benign disease (p=0.0039).
Conclusions:
- Primary mediastinal masses in this population are predominantly symptomatic.
- Benign conditions are more likely to be asymptomatic compared to malignant ones.
- Lymphoma is the leading histological type, with a predilection for the anterosuperior mediastinum.
Objectives:
To determine clinical features, anatomic location and histological types of primary mediastinal masses diagnosed and treated in a black African population.
Design:
A retrospective study of clinical data collected from patients case notes, the cardiothoracic unit's and pathology records between June 1975 and May 1999.
Setting:
University College Hospital, Ibadan, Nigeria which hosts a major cancer center in the West African sub-region, and serves community clinics.
Patients:
All patients with primary mediastinal masses referred for evaluation and treatment.
Main Outcome Measures:
Excluded metastatic, oesophageal and vascular-lesions. All patients had radiological evalulation and tissue biopsies. The anatomic subdivision of the mediastinum into anterosuperior, middle and posterior section was used.
Results:
One hundred and five consecutive patients were evaluated and treated. The mean age was 34.0 +/- 20.4 years. There were 75 males and 30 females. Eighty one (77.1%) were symptomatic, 24 (22.9%) were asymptomatic. Thirty seven (45.7%) of the symptomatic patients had malignant disease while 44 (54.3%) had benign disease. Forty five patients (43%) and 60 patients (57%) had malignant and benign diseases respectively. Incidence of symptoms, was 82.2% for malignant and 73.3% for benign diseases. This difference in incidences is statistically insignificant (p=0.283). Majority of asymptomatic patients (70.8%) had benign disease while 29.2% of patients with malignancy were asymptomatic. This difference in incidence was statistically significant (p=0.0039). The frequency of mediastinal masses were anterosuperior, in 67 patients (63.8%), posterior mediastinal, 24 patients (22.9%) and middle mediastinal in 14 patients (13.3%). Lymphoma 23 (21.9%), thymus glands tumours 19 (18.1%) and endocrine tumours (goiters) 18 (17.1%) were the commonest types of primary mediastinal masses treated.
Conclusion:
Majority of our patients with mediastinal masses (whether benign or malignant) are symptomatic and the absence of symptoms is more associated with benign disease. Majority of lesions are situated in the anterosuperior mediastinum. Lymphoma is the most frequent primary mediastinal mass.
