[Benign primary cystic lesions of mediastinum in adult: the clinical spectrum and surgical treatment]. / Lesiones quísticas primarias y benignas del mediastino en el adulto: espectro clínico y tratamiento quirúrgico.

ABSTRACT

BACKGROUND AND OBJECTIVE: The mediastinal cysts form a group of heterogeneous and uncommon benign lesions of neoplastic, congenital, or inflammatory conditions. The forgoing controversy is how to manage them; surgical removal or observation. We reviewed our experience including some rare conditions, emphasizing the clinical spectrum and surgical treatment. PATIENTES AND METHODS: This is a retrospective review between 2000 and 2007 included 34 cases of primary mediastinal cystic lesions. Clinical features, imaging techniques, surgical operation, morbidity, mortality and follow-up were analyzed. RESULTS: There were 18 females (53%) and 16 males (47%), with a mean age+/-standard deviation of 45.3+/-14.1 years (range 22-74). Most of cysts were congenital (94%), except patients with hydatid disease (6%). 24% of cysts (n=8) were detected in anterior mediastinum. Rest of them (n=26) were located in visceral mediastinum. Patients usually were symptomatic (61%). Chest pain and discomfort was most common symptom, others were dyspnea, cough and hemoptysis, respectively. Cysts excision was performed in all cases with an uneventful recovery and with no recurrence in long term follow up. CONCLUSIONS: Asymptomatic mediastinal cysts are not rare. Surgery is a reliable method of treatment of mediastinal cysts with acceptable mortality and morbidity.