Spontaneous Disappearance of a Pericardial Cyst: Case Report and Literature Review / 대한흉부외과학회지

Pericardial cysts are rare benign anomalies generally discovered as incidental findings on radiographic images. Rarely, pericardial cysts cause symptoms and may lead to complications. A 56-year-old woman presented to the emergency department for mild chest pain. A cardiovascular and respiratory examination revealed no abnormalities, while a chest X-ray and subsequent thoracic computed tomography (CT) showed a pericardial cyst. The patient refused both percutaneous treatment and thoracic surgery. Three years later, a thoracic CT scan showed that the pericardial cyst had disappeared. Although the spontaneous resolution of these lesions is rare, this article highlights the possibility of conservative management in select cases.

Complicated Azygos Vein Aneurysm in an Infant Presenting with Acute Pulmonary Thromboembolism

Azygos vein aneurysm is a rare cause of mediastinal mass. Most cases present as an incidental finding on imaging modalities, but in few cases the thrombosis in the aneurysm leads to pulmonary thromboembolism, which may require surgical resection. We present a case where, for the first time, a case of a complicated azygos vein aneurysm was diagnosed in infancy, which required surgical resection.

Utilidad de la mediastinoscopia: resultados de 140 procedimientos / Mediastinoscopy: experience with 140 procedures

Objetivo: determinar la sensibilidad y especificidad de la mediastinoscopia para diagnóstico y estadiaje de enfermedades del tórax. Métodos: se revisó la información general incluida en la base de datos del servicio de Cirugía de Tórax del Hospital Dr. R. A. Calderón Guardia, de 140 pacientes sometidos a mediastinoscopia durante el periodo comprendido entre 1989 y 2013, la cual se complementó con datos específicos obtenidos de los expedientes clínicos...

Diagnostic value of endoscopic ultrasonography guided fine-needle aspiration in identifying mediastinal benign and malignant lesions / 中国综合临床

Objective To evaluate the feasibility,safety and accuracy of endoscopic ultrasonography guided fine-needle aspiration(EUS-FNA) in patients with mediastinal benign and malignant lesions.Methods A linear array scanning endosonography (Pentax-EG3630U) and a 22-guage (Wilson-CooK) needle were used to perform EUS-FNA in 22 patients with mediastinal lesions.Results EUS-FNA revealed 15 patients with carcinoma and 6 cases with benign tumors,which were confirmed by mediastinoscopy.One patient was not diagnosed because of inadequate specimen.None of the patients had complications caused by any procedures.Conclusion EUS-FNA is safe,reliable and accurate in diagnosis of mediastinal benign and malignant lesions.

Surgical Treatment of Mediastinal Aspergilloma in a Immunocompetent Patient

Aspergillus is a common saprophytic fungi of the human airways and causes a broad spectrum of diseases, ranging from aspergilloma to invasive aspergillosis. There are few reports on mediastinal aspergilloma without any underlying pulmonary disease or immunocompromise. Herein, we report a case of mediastinal aspergilloma that we experienced and treated by thoracoscopic resection and oral antifungal medication.

Single-Incision Video-Assisted Thoracoscopic Surgery for Benign Mediastinal Diseases: Experiences in Single Institution

With advancement of the technique of video-assisted thoracic surgery (VATS), some surgeons have made great efforts to reduce the number of incisions in the conventional three- or four-port approach. Several studies on cases treated by single-incision VATS and their short-term outcomes were reported. Here, we present our experience with single-incision VATS for the treatment of benign mediastinal diseases.

Ectopic Pancreas with Hemorrhagic Cystic Change in the Anterior Mediastinum

A 31-year-old female was referred from other hospital due to migrating chest pain, mild cough, and blood-tinged sputum for three days before admission. Laboratory tests were unremarkable. Chest computed tomography revealed an elliptical necrotic mass at the left anterior mediastinum, measuring 7x3x4 cm. With the impression of mediastinal abscess or loculated empyema, thoracoscopic resection was performed. There was severe pleural adhesion around the mass. The mass could be resected by the wedge resection of the adhesed upper lobe tissue of left lung around the mass. Final pathologic diagnosis was ectopic pancreas.

Surgical Treatment of Thoracic Menigocele Associated with Neurofibromatosis and Kyphoscoliosis

A 46-year-old man presented with a lateral thoracic meningocele associated with cutaneous neurofibromatosis type I and kyphoscoliosis of the thoracic spine upon medical examination. In the majority of such cases, these meningoceles remain asymptomatic, but surgery is indicated when giant or symptomatic cysts are present. The large thoracic meningocele was successfully extirpated through the transthoracic approach in combination with lumbar puncture and cerebrospinal drainage for decompression of the cyst.

Pneumomediastinum and Subcutaneous Emphysema after Dental Treatment / 대한흉부외과학회지

The pneumomediastinum after a dental treatment occurs rarely and shows almost good prognosis, however it is potentially life-threatening complication. Here we report a case of pneumomediastinum, occurred by air bubbles originated from dental high speed equipment, via head and neck fascial space with literatures review.

Mediastinoscopic Resection of A Paratracheal Bronchogenic Cyst: A case report / 대한흉부외과학회지

Bronchogenic cysts (BCs) are relatively common congenital anomalies in the mediastinum. Most of the patients with BC can be managed both safely and effectively by minimally invasive methods. Selected patients with a BC in a favorable location can have the cyst partially or completely excised by mediastinoscopic techniques. Herein we report on a case of a left lower paratracheal bronchogenic cyst that was completely resected by a video-assisted mediastinoscopic technique, and we discuss the technical aspects of this procedure.

Mediastinal Heterotopic Thyroid Tissue : A case report / 대한흉부외과학회지

A 47-year old woman was admitted to our hospital for removal of a known mass that was located on the suprasternal notch; specifically, the mass was located on the supero-anterior mediastinuum. The mass was removed by a cervical incision and the histopathologic diagnosis of the resected specimen was hererotopic thyroid tissue with nodular hyperplasia. Mediastinal hererotopic thyroid tissue is a rare malady, so we report here on a case of mediastinal hererotopic thyroid tissue and we review the relevant medical literature.

Intrapericardial Pericardial Cyst / 대한흉부외과학회지

Pericardial cyst is an uncommon congenital mediastinal tumor. The majority of pericardial cysts are located in the right cardiophrenic angle, but rarely they can be located intrapericardially. We now present a case of a huge intrapericardial pericardial cyst excised with video-assisted thoracoscopic surgery.

Paragonimiasis with Simultaneous Multifocal Lesions / 대한흉부외과학회지

A 42-years-old man was referred to our department due to his hemoptysis. Chest CT showed a cavitary lung lesion in the apical segment of the RUL and an anterior mediastinal mass. The patient underwent wedge resection for the cavitary lesion and complete resection for the mediastinal mass. The pathologic finding was Paragonimus Westermani infestation in both the lung and thymus. The abdomen CT taken postoperatively showed an inflammatory mass involving the transverse colon and a small nodular lesion around the descending colon, which strongly suggested paragonimiasis. Postoperatively, the patient took Praziquantel for 2 days and he was discharged without any complications. There was no evidence of recurrence for the last 2 years.

Idiopathic Mediastinal Fibrosis (2 case) / 대한흉부외과학회지

Idiopathic mediastinal fibrosis is very rare. We report two cases of a 41-year-old man and 65-year-old man who presented with backache and vocal cord palsy, subsequently confirmed to be idiopathic mediastinal fibrosis. Preoperative chest computed tomography showed a mediastinal mass and oracoscopic biopsy was preformed. The mass was hard, dense and partially calcified, and adhered the adjacent mediastinal structure. Postoperative medical treatment was not performed, and during 5 and 7 month follow-up has not demonstrated any complication.

Mediastinoscopy for the diagnosis and differential diagnosis of undifferentiated mediastinal diseases / 中国微创外科杂志

Objective To evaluate the value of mediastinoscopy in the diagnosis of undifferentiated mediastinal diseases. Methods A total of 35 mediastinoscopies were performed for patients with undifferentiated mediastinal disease from November 1999 to February 2002 and suspicious tissues at peritracheal,retrosternal,subcarinal,or bilateral hilar areas were obtaiued for pathological examination. Results Thirty four of 35 patients with undetermined mediastinal diseases had definite pathologic diagnosis.The diagnosis accuracy was 97%(34/35).Of the 34 patients,18 were diagnosed as malignant accounting for 52.9%.Sixteen of the 34 were diagnosed as benign,accounting for 47.1%.The diagnostic consistency of preoperation and postoperation was 47.1%(16/34).The misdiagnosis of preoperation was 52.9%(18/34).In this series,the benigns were apt to lead to misdiagnosis.10 of 16 patients with benign disease were diagnoscd as initially malignancies,representing 62.5%.In the entire group one patient had complications (2.9%).Yet no perioperative death occurred. Conclusions Mediastinoscopy is a valuable procedure which helps mede a correct diagnosis of mediastinal diseases.Given its safety and usefulness It is suggested that mediastinoscopy should be used routinely in the diagnosis of undifferentiated mediastinal diseases.

Cinical Evaluation of Transesophageal Echocardiography Applied to Diagnose the Mediastinal Teratoma / 中国医师杂志

Objective To probe the clinical value of transesophageal echocardiography(TEE) in diagnoses of mediastinal teratoma.Method Differential diagnosis of benign or malignant tumor was carried out on the bases of echocharacteristics,size,capsule lesion,boundary,growing speed,invasion and compression of tumor etc with TEE in twenty cases of mediastinal teratoma.Results The sensitivity,specificity and accuracy of the TEE diagnosis for mediastinal teratoma were 70%,94%,90% respectively.Conclusion TEE has an important value for diagnosis of mediastinal teratoma.

Treatment of Esophageal Stenosis by Idiopathic Mediastinal Fibrosis: A case Report / 대한흉부외과학회지

Mediastinal fibrosis is uncommon but may result in entrapment and erosion of vital mediastinal structures by fibrous tissues. Idiopathic mediastinal fibrosis involved esophagus is very rare, and only a few cases have ever been reported. Such idiopathic mediastinal fibrosis involved esophagus is an enigmatic inflammatory fibrous tissue proliferation, but the treatment has not yet been clearly defined. We had successfully treated in such a case with partial esophagolysis and esophagomyotomy.

Video-mediastinoscopy in the diagnosis of mediastinal tumor and the staging of lung cancer / 中国微创外科杂志

1.0 cm) by radiographic examinations, video-mediastinoscopy showed positive results in 30 cases, and negative in 14 cases, in which the surgical exploration found no evidence of metastasis to mediastinal lymph nodes. No postoperative complications and mortality were observed. Conclusions Video-mediastinoscopy offers clear operation field, high resolution, convenient application, safety and reliability. We suggest that it be adopted as a routine method in the diagnosis of mediastinal tumor and the staging of lung cancer.

Video-assisted Thoracoscopic Surgery for Mediastinal Lesions / 대한흉부외과학회지

Recently, video-assisted thoracoscopic surgery for mediastinal lesions has been considered a new effective therapeutic method. From March, 1992 to April, 1997, 33 cases of video assisted thoracoscopic surgery for mediastinal lesions were performed. Gender distribution was 16 males and 17 females. Average age was 42 years old (ranged from 14 to 69). The locations of lesions were anterior mediastinum in 14 cases, middle mediastinum in 5 cases, posterior mediastinum in 11 cases, and superior mediastinum in 3 cases. These included 9 neurilemmomas, 5 benign cystic teratoma, 4 pericardial cysts, 2 ganglioneuroma, 2 thymus, 2 thymic cyst, 1 thymoma, 2 esophageal leiomyomas, 1 dermoid cyst, 1 lipoma, 1 malignant lymphoma, 1 bronchogenic cyst, 1 pericardial effusion, and 1 Boerhaave's disease with empyema. Working window was needed in 6 cases. We converted to open thoracotomy in 6 cases. Reasons of convertion to open thoracotomy were large sized mass (1), severe adhesion (3), and difficult location to approach (2). The average operation time was 116min (+/-56 min). The average chest tube drainage time was 4.7days. The average hospital stay was 8.7 days. Operative complications were atelectasis (2), empyema with mediastinitis (1), recurrent laryngeal nerve palsy (1), and plenic nerve palsy (1). In conclusion, VATS for mediastinal lesions were performed with shorter operation time and hospital stay, and lesser complications and pain than those of conventional thoracotomy.