Single-Center Experience of Management of Mediastinal Cyst-A Case Series.

Background Mediastinal cysts are benign lesions that may be seen in adulthood as well as in childhood. Mostly congenital lesions constitute 20 to 32% of lesions located in the mediastinum. The main cystic masses are congenital benign cysts (bronchogenic, esophageal replications, neuroenteric, pericardial and thymic cysts), meningocele, mature cystic teratoma, and lymphangioma. In this study, we aimed to analyze the mediastinal cysts operated in our clinic according to the histopathological type, surgical type, morbidity rates and to contribute to the literature on these rare lesions. Methods The records of patients with mediastinal cysts who were operated in Gazi University Faculty of Medicine Department of Thoracic Surgery, between January 2013 and June 2021, were reviewed retrospectively. Results A total of 32 patients were included the study. Thirteen (40.6%) of the patients were male and 19 (59.4%) were female. The mean age was 45 (range: 12-71). The most common symptom in patients was chest pain with 12 patients. Histopathologically, the most common subtype was thymic cyst. Video-assisted thoracic surgery was applied in 19 patients (59.3%), thoracotomy in 8 patients (25%), and sternotomy in 5 patients (15.63%). There was no mortality. Conclusion In patients with mediastinal cysts, the prognosis after complete excision is excellent and rates of morbidity and mortality associated with surgery are low.

A case of bi-focal mediastinal ependymoma.

Ependymomas are tumors located in the central nervous system, mostly in the brain and spinal cord. This tumor is rarely seen as a primary mediastinal location. The aim of this study is to discuss this rare pathology in the clinical course of an unusual case. A 47-year-old female patient was referred to our clinic with the complaint of back and shoulder pain, via VATS posterior mediastinum located paravertebral mass excision was performed. The pathology reported as ependymoma. Two years later, CT scans of the routine control showed the well-defined mass in anterior mediastinum. The SUVmax of the lesion was measured as 9.3 at PET-CT. The lesion in the anterior mediastinum was excised by partial sternotomy. The pathology result was the same as the prior operation: Ependymoma. As our case, in these kinds of tumors meticulous follow-up of the patients is important for the detection and treatment of recurrent localization and distant metastases.

Giant bronchogenic cyst mimicking tension pneumothorax.

An 18-month-old girl presented with high fever and vomiting. Pneumothorax and a cystic formation in the right hemithorax were found on a chest radiograph. The cyst measuring 10 x 10 x 8 cm was resected by a simple wedge resection. Histology revealed a complicated bronchogenic cyst with abscess formation.

Benign fibrous histiocytoma of the trachea.

Benign fibrous histiocytoma of the trachea is a rare neoplasm. We reported 2 cases, one aged 3 years and one 5 years, with endotracheal fibrous histiocytoma showing no clinical evidence of malignancy. Two segments of the trachea were resected and an end-to-end anastomosis was done in 1 case and circular resection of the left bronchi and carinoplasty for the other. Pathologically, both tumors consisted of spindle cells arranged in storiform and fascicular patterns. Immunohistochemically, tumor cells stained for vimentin and CD68 but were negative for P53. These cellular features and immunohistochemical findings indicate benign fibrous histiocytoma of the trachea. No recurrence was seen.