Clinical Spectrum of Mediastinal Cysts: Discussion

Clinical Spectrum of Mediastinal Cysts: DiscussionThree patients with bronchogenic cysts were converted to standard thoracotomy because of severe adhesions around the cysts, particularly into the esophageal muscle layers. Three patients with pericardial cysts had a communication with the pericardial cavity, which were found during surgery, thoracoscopic fenestration was performed. One female patient with a thymic cyst had a concurrent neurogenic tumor in the posterior mediastinum; therefore, the thymic tumor was resected via a median sternotomy as an initial diagnosis of thymoma, and a neurogenic tumor was removed via a posterolateral approach concurrently.
Specimens were available for pathologic examination in all patients, which revealed typical features of bronchogenic, esophageal, thymic, and thoracic duct cysts or meningoceles. Some patients with the entire cystic mass in the thymus, found to be cystic thymoma, were excluded from this study. There were no major morbidity or mortality in the surgical treatment of mediastinal cysts, and all patients had uneventful recovery.

Mediastinal cysts are relatively uncommon but easily diagnosed by routine radiographic imaging procedures. These cysts comprise 12 to 30% of all primary mediastinal masses. Mediastinal cysts were further classified into foregut-derived cysts, which represented more than half of cystic lesions of the mediastinum, mesothelial cysts including pericardial pleural cysts, thymic cysts, and other rare anomalies such as thoracic duct cysts or meningoceles. We herein reviewed our experience with 105 mediastinal cysts, including some rare mediastinal cysts,
Incidence and Embryogenesis
Foregut cysts, including bronchogenic and esophageal cysts, represented 48.6% (51 of 105 cysts) of all cysts in the mediastinum.

Category: Cysts

Tags: bronchogenic cysts, foregut cysts, Japanese experience, mediastinal cysts, mesothelial cysts, symptomatology