Clinicopathological Profile of Primary Mediastinal Masses: Our Experience

Abstract

Background: Primary mediastinal masses are uncommon lesions encountered in clinical practice and the source of origin of these masses can be an enigma for the clinicians. These masses can be neoplastic, congenital, or inflammatory in nature. The data regarding their true incidence and the clinicopathological profile they present with is scarce due to their rarity. The clinical manifestations of these masses are usually nonspecific and protean. A standardized diagnostic workup is essential for their early detection and proper management. We retrospectively analyzed the clinicopathological profile of 29 cases of mediastinal masses diagnosed and operated in the department of General Surgery at a tertiary care hospital over a period of 11 years (2008-2019). Aims and objectives: The study aims to assess the clinical profile of adult patients with primary mediastinal masses that presented to General Surgery department at Government Medical College and Hospital, Chandigarh (India). Study design: This was a retrospective, descriptive and cross-sectional study of 11 years in which 29 patients of primary mediastinal masses with a definitive pathologic diagnosis after surgical resection were included. Detailed clinical profile, radiological and pathological findings along with their management outcome was noted. Results: Maximum numbers of cases were symptomatic at presentation and presented with non-specific symptoms. Maximum numbers of cases were found to be in the 3rd decade of life. Anterior mediastinal masses are encountered more frequent as compared to middle and posterior compartments. Male to female ratio was almost equivalent and benign tumor predominated in this study. Diagnostic workup included thorough radiological assessment using Chest X-Ray and Contrast Enhanced CT scan (CECT). FNAC and/or biopsy were performed as and when required. Final histopathological analysis after surgical resection revealed 6 cases of thymoma, 6 cases of teratoma, 5 cases of neurofibroma, 3 cases of retrosternal goitre, 2 benign epithelial cyst, 2 schwannoma, 1 case each of bronchogenic cyst, ganglioneuroma and chylo-lymphatic cyst. Conclusion: Majority of the patients of primary mediastinal masses present with non-specific chest pain and/or symptoms of compression at the time of their first visit to the hospital. Early detection is the key for prompt surgical intervention to reduce the overall morbidity associated with these masses.