[SUCCESSFUL TREATMENT OF A CASE OF BRONCHOGENIC MEDIASTINAL CYST IN A CHILD].
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A 69-year-old woman visited our hospital for further investigation of a prominence at the right heart border. Chest X-ray, tomography, CT scan and ultrasonography revealed an anterior mediastinal cyst. After admission, we performed needle aspiration, injection of contrast material and drainage. Since the lesion was diagnosed as a benign mediastinal cyst, the patient has been followed up without surgery. CT scan after a two-year period revealed fatty tissue in the area of the lesion without evidence of recurrence.
During the years 1968-1988 270 patients with tumors and mediastinal cysts were treated surgically. In 48 (17.8%) cysts were found (26 males, 22 females, age ranged 10-63 years, mean 40.1 years). In 24 pericardial cysts were found. In 24 the cysts derived from the forgut. 23 subjects (47.9%) were symptomless. In all the cysts were removed. Mortality was not seen. 47 patients are included in long-term observation.
A 52-year-old woman with left posterior mediastinal cyst underwent surgical removal using thoracoscopy. Under general anesthesia by use of one lung ventilation, thoracoscopy was introduced through a trocar at the mid-axillary line of the 7th intercostal space. Grasping forceps were introduced through a incision in the anterior-axillary line of 4th and 5th intercostal space. The lung was held with grasping forceps. The lung was fixed to the region of anterior-mediastinum with the weight of forceps. Then posterior-mediastinum was able to be observed well by the operator. The thin cyst-wall was biopsied and excised as much as possible. Residual cyst-wall was burned by electric knife. A pathological diagnosis probed that the tumor was bronchogenic cyst without malignancy. Post operative pain markedly reduced. The patient rapidly recovered and was discharged on the 6th postoperative day. Thoracoscopic resection of mediastinum cyst may be a useful approach.
Current videoendoscopic technology and percutaneous techniques of exposure and dissection have been successfully applied to abdominal surgery with favorable results. Application of this technology to our practice of thoracic surgery is the basis of this report. Video-assisted thoracic surgery was performed in 36 patients for the following indications: Raynaud's syndrome, undefined pulmonary nodule, persisting spontaneous pneumothorax, T1 bronchial carcinoma, and mediastinal cyst. Videoendoscopic surgical procedures were accomplished using double-lumen endotracheal anaesthesia and a percutaneous stapling device. Procedures performed using this technique include thoracic sympathectomy, wedge or keel excision, blebectomy, lung apex stapling, parietal pleurectomy, and dissection of the mediastinal cyst. Median operating time was 45 min (range, 15 to 90 min). Tissue diagnosis was obtained in all patients. Median diameter of excised nodules was 10 mm (range, 7 to 70 mm). There were no operative deaths. The single complication was a prolonged air leak. This new method of thoracic surgery appears to benefit the patients. For us it proved a secure way to perform thoracic surgery. Our case of removal of a benign cyst in the posterior mediastinum shows that video-assisted thoracic surgery has expanding applications in the field of general thoracic surgery.
Mediastinal foregut cysts account for approximately 10% of primary mediastinal masses. The differentiation of these cysts from other mediastinal masses is important, especially if a policy of aspiration and observation of cysts is adopted. Computed tomography (CT) is generally regarded as the definitive imaging modality in these cases, but it may occasionally fail to identify the cystic nature of the mass. We report a case in which transoesophageal ultrasound contributed to the diagnosis and demonstrated features of the cyst contents that were not visible on CT.
The authors report a case of anterior mediastinal cyst discovered incidentally in a 71-year-old man presenting with prolonged chest pain and a history of chronic renal failure secondary to polycystic kidney disease. The diagnosis of these cysts, which are benign congenital tumours usually asymptomatic and with a favourable course, was established by thoracic CT. In difficult cases, magnetic resonance imaging allows precise analysis of pericardial masses. Clinicians should think of this possibility in the presence of an opacity of the cardiophrenic angle associated with chest pain.
A case of calcified pericardial cyst is reported and is differentiated from calcified bronchogenic, enteric, thymic, terato-dermoid, and hydatid cysts by means of roentgenology and pathology.
Previously, intrathoracic organs have been approached by either thoracotomy or thoracoscopy. A technique, imaged thoracoscopic surgery, using video optics and projection of images on a screen provides another option for the thoracic surgeon. Two patients with mediastinal cysts, one bronchogenic and one esophageal, underwent surgical removal using imaged thoracoscopic surgery. Postoperative pain was markedly reduced, hospitalization shortened, and recovery accelerated. Numerous complex surgical procedures can be performed using imaged thoracoscopic surgery.
The authors present a case report on a 60-year-old female patient suffering from benign mediastinal cyst, arterial hypertension and porphyria. CT-guided transparietal fine-needle punction was done simultaneously as a diagnostic and a therapeutic procedure. Partial regression of the cyst was still apparent at the check CT investigation after six months. The examination of the level of immunoglobulins in the fluid obtained during transparietal punction confirms the diagnosis of bronchogenic cyst.
In the clinic there were operated on 8 patients with bronchogenic and enterogenic mediastinal cyst, complicated by intrathoracic compression of respiratory ways. In 2 children postoperative complications occurred. In presence of secondary tracheomalacia, caused by tracheal compression by bronchogenic cyst, aortopexy was done in conjunction with the cystic formation excision. All the patients survived. In 6 children satisfactory result was noted, in 2--relatively satisfactory one.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.