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Adnan Sayar
Akif Turna
Atilla Gürses
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Ann Thorac Surg 2002;73:250-252
© 2002 The Society of Thoracic Surgeons

Original article: general thoracic

Extended cervical mediastinoscopy in the diagnosis of anterior mediastinal masses

Muzaffer Metin, MDa, Adnan Sayar, MDa, Akif Turna, MD*a, Atilla Gürses, MDa

a Yedikule Hospital for Chest Disease and Thoracic Surgery, Zeytinburnu, Istanbul, Turkey

Accepted for publication July 30, 2001.

* Address reprint requests to Dr Turna, Cami Sok. Muminderesi Yolu. Emintas Camlik Sit. No:32/22, Sahrayicedid, Kadikoy 81080 Istanbul, Turkey
e-mail: aturna{at}turk.net

Background. Although transthoracic needle biopsy (TNB) has been the preferred method for the diagnosis of anterior mediastinal masses, it has inherent limitations in accuracy. In particular, lymphoma and thymoma are diagnosed less reliably using needle biopsy. Videothoracoscopy has been advocated as an alternative method for diagnosis. Our goal was to assess the usefulness of extended cervical mediastinoscopy (ECM) in the diagnosis of anterior mediastinal masses.

Methods. The ECM technique was performed in 9 patients in whom TNB and Tru-cut biopsies had been inefficient for histologic diagnosis. All lesions were in the anterior mediastinum. Extended cervical mediastinoscopy was carried out using the same incision as in a standard cervical mediastinoscopy and dissection was performed behind the sternum as previously published. Mean operative time was 50 minutes (range 40 to 70 minutes) and mean hospital stay was 8 hours (range 5 to 36 hours).

Results. Diagnosis of lymphoma in 4 cases, thymoma in 3 cases, and thymic hyperplasia in 2 cases were obtained by ECM. In 1 of 2 patients with suspected thymoma who underwent resectional surgical procedures, final histologic diagnosis was non–small cell lung carcinoma. There was no surgical mortality or intraoperative complication. One patient had minimal pneumothorax requiring no intervention.

Conclusions. We conclude that ECM in the diagnosis of anterior mediastinal masses is technically feasible and provides an alternative to the conventional approaches in patients with paraaortic or aortopulmonary masses.




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V. Annessi, M. Paci, G. Ferrari, and G. Sgarbi
Ultrasonically guided biopsy of anterior mediastinal masses
Interactive CardioVascular and Thoracic Surgery, September 1, 2003; 2(3): 319 - 321.
[Abstract] [Full Text] [PDF]


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