Selective operative approach for diagnosis and treatment of anterior mediastinal masses

Journal Article · Tue Dec 01 04:00:00 EST 1987 · Ann. Thorac. Surg.; (United States)

DOI:https://doi.org/10.1016/S0003-4975(10)62139-X· OSTI ID:5724078

Ferguson, M K; Lee, E; Skinner, D B; Little, A G

We retrospectively reviewed the records of 41 patients with an isolated anterior mediastinal mass to identify whether the traditional surgical approach of resection for both diagnosis and therapy is the optimal approach to these tumors. In addition to plain chest radiographs, clinical evaluation included computed tomography (CT) in 23 and gallium scintigraphy in 23. The initial intervention was attempted excisional therapy in 16 and mediastinoscopy for biopsy in 25. Pathological diagnoses included lymphoma (13), thymoma (11), germ cell tumor (6), carcinoid (2), bronchogenic carcinoma (2), and other benign processes (7). Based on histological findings, nonoperative therapy was the most appropriate treatment in 61%. The clinical selection of the surgical approach was not aided by patient age, symptoms, or findings on CT. The gallium scan was positive in 13 of 15 patients for whom nonoperative therapy was appropriate, and was normal in 7 of 8 for whom excision was indicated. Mediastinoscopy is useful in the diagnosis of anterior mediastinal masses, and may eliminate unnecessary thoracotomy, especially when a gallium scan is positive.

• Research Organization: Univ. of Chicago Medical Center, IL
• OSTI ID: 5724078
• Journal Information: Ann. Thorac. Surg.; (United States), Journal Name: Ann. Thorac. Surg.; (United States) Vol. 44:6; ISSN ATHSA
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
BIOMEDICAL RADIOGRAPHY
BIOPSY
BODY
BODY AREAS
CHEST
COMPUTERIZED TOMOGRAPHY
COUNTING TECHNIQUES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
MEDIASTINUM
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
PATIENTS
RADIOISOTOPE SCANNING
RADIOLOGY
SCINTISCANNING
SURGERY
TOMOGRAPHY