Zystische Raumforderung im hinteren Mediastinum

We present the case of a 52-year-old male who underwent thoracotomy for resection of a suspected bronchogenic cyst in the right posterior mediastinum. The size of the tumor had increased over years, according to repeated X-rays, and the cyst became symptomatic with obstruction of the right subclavian and jugular veins. To our surprise, histopathology revealed a hydatid cyst.     

电视胸腔镜下纵隔囊肿切除术12例报告

本文报道2011年2月～2012年2月12例胸腔镜纵隔囊肿切除术,囊肿位于前纵隔7例,中、后纵隔5例,长径2．5～13．5cm。手术时间65—150min,平均90min。无并发症。9例术后随访5—18个月,平均9．5月,无复发。术后病理：胸腺囊肿4例,支气管囊肿3例,心包囊肿3例,食管囊肿2例。     

Two cases of the bronchial cyst located in the anterior mediastinum]

Bronchial cysts are common cystic tumors around the tracheobronchial tree in the middle and posterior mediastinum and rarely locate in the anterior mediastinum. We reported two cases of the bronchial cyst located in the anterior mediastinum. One case was a 57 year-old-female. A thymic cyst was suspected and the extended total thymectomy was performed through the mediansternotomy. The microscopic examination showed bronchial epithelium and cartilage in the cystic wall. The another case was 71 year-old-male operated by thoracoscopic surgery for the cystic tumor in the anterior mediastinum. Microscopic examination showed bronchial epithelium and gland in the cystic wall.     

Primary hydatid cysts of the mediastinum.

Hydatid disease remains a serious health problem for the Mediterranean countries, such as Turkey. Living in a rural area is an important risk factor for the disease. Hydatid cysts are usually located in the liver, lung, and brain. Mediastinal hydatid disease is very rare that have been only anecdotally in the literature. The objective of this study was to evaluate the clinical and radiographic findings and surgical treatment of this unusual lesion. Between 1985 and 2002, 11 cases with primary mediastinal hydatid cyst were treated surgically at our clinic. Median age was 28.4 and ranged from 19 to 46 years. Symptoms included chest pain in nine patients (82%), and cough in six patients (54%). The cyst was located in the anterior mediastinum in four patients (36%), in the posterior mediastinum in five patients (45%) and in the middle mediastinum in two patients (18%). All cysts were intact except one cyst that ruptured into right intrapleural space. Surgical approach was right thoracotomy in five patients (45%), left thoracotomy in three patients (27%), and median sternotomy in three patients (27%). Total pericystectomy was chosen as the surgical procedure in all patients except four (36%), who had cystectomy and local curettage for cyst located vital structures. There were no complications and mortality postoperatively. Primary hydatid cysts of the mediastinum are distinct clinical entity that must be considered when caring for a patient with a mediastinal mass in endemic regions. Because of surrounding vital structures the cyst should be treated without delay.     

Enterogenous cyst of the testis

Enterogenous cyst is a rare congenital lesion generally located in the mediastinum or the abdominal cavity. We reported the first case of testicular enterogenous cyst in a 55-year-old white male presented with testicular pain and a gradually enlarging left scrotal mass with a 2-week duration. （Asian J Androl 2006 Mar; 8： 243-245）     

Bronchogenic cysts above and below the diaphragm: report of eight cases

Bronchogenic cysts are developmental foregut anomalies usually located within the mediastinum. Although typically asymptomatic, infection or compression of adjacent structures may become prominent. Surgical excision is recommended to establish diagnosis, alleviate symptoms if present, and prevent future complications. We report our recent experience with bronchogenic cysts including 7 located within the mediastinum and a rare instance of a cyst below the diaphragm.     

Thoracic duct cyst--a case report

A case of thoracic duct cyst was reported. The patient, 72 year old man, was admitted with chief complaint of dysphagia. Chest X-ray film demonstrated an ovoid mass at the right upper mediastinum and the esophagus pressed by the tumor to the right. CT scan showed a round tumor with obscure margin located at the right upper mediastinum. Other laboratory data were almost within normal limits. Thoracotomy was performed on March 26, 1987 under diagnosis of leiomyoma of the esophagus. A fluid containing cyst covered with pleura was found at the upper mediastinum. The tumor was connected to the thoracic duct at its upper and lower portion. The cyst was isolated by sharp and blunt dissection without difficulties and removed. The cyst measured 7.5 X 4.5 X 4.5 cm and contained chyle. Pathological examination revealed no evidence of malignancy. Postoperative course of this patient was uneventful, and dysphagia was disappeared.     

Total Occlusion of the Superior Vena Cava Due to Bronchogenic Cyst

Bronchogenic cysts are the most common form of congenital cystic lesions in the mediastinum. Of all cases with bronchogenic cysts, 1/3 are symptomatic. The symptoms vary depending on the location and compression of the adjacent structures of the cyst. Some mediastinal bronchogenic cysts can cause severe respiratory distress due to airway and vascular compression. We herein present a case with a bronchogenic cyst that required venoplasty to the superior vena cava (SVC) due to total occlusion of the SVC.     

Bilocular pericardial cyst in an aberrant location

Pericardial cysts classically are found in the right or left cardiophrenic angle and rarely are located outside of this location. An 82-year-old man presented with an asymptomatic cystic mass on chest CT-scan located in the upper right mediastinum and measuring 7 x 6 x 4 cm. A follow-up chest CT-scan 12 months later showed that the cyst had increased in size to where it now measured 10 x 9 x 8 cm and was noted to be dislocating and compressing the superior vena cava. The patient underwent surgical excision because of the uncertain diagnosis and the compression of contiguous organs. Two cystic masses were able to be completely excised intact. A definitive diagnosis of double pericardial cyst was histopathologically confirmed. Radiological findings of a pericardial cyst in the upper mediastinum are extremely rare. In particular there have been no reports of bilocular or double pericardial cysts.     

A case of double mediastinal tumors]

We reported a pediatric case of double mediastinal tumors. A 7-year-old girl was admitted to our hospital as the abnormal shadows were pointed out on her chest x-ray film. CT scan and MRI suggested the existence of double tumors located at the anterior and middle mediastinum. Both tumors and thymus were removed. Histological diagnosis of one tumor was teratoma of the anterior mediastinum and another was bronchogenic cyst of the middle mediastinum respectively. Pertinent literatures were reviewed.     

Pericardial cyst located in the anterior mediastinum mimicking a thymoma. A presentation of two cases

Pericardial cysts are rare but well recognized tumors of the mediastinum. Most pericardial cysts are located in the right or left cardiophrenic angle. At other locations these cysts may pose a diagnostic problem. We present two cases of an atypically located pericardial cyst and a short review of the literature.     

Giant multilocular thymic cyst in an HIV-infected adolescent

A girl with vertically acquired HIV infection presented with a 6-month history of dyspnea and chest pain. Computed tomography of the thorax showed a heterogenous mass measuring 13 × 9 × 17 cm located in the anterior mediastinum. Complete surgical resection was accomplished with no complications. The final diagnosis was multilocular thymic cyst, a distinct pathologic entity that is morphologically distinguishable and unrelated to congenital thymic cyst.     

Primary retroperitoneal enteric cyst in an adult

The posterior mediastinum is the usual location of enteric cysts. They can be located at any part of the posterior mediastinum adjacent to the oesophagus, but communication with that structure is rare. Approximately 60 percent of the cysts occur in infants less than one year of age, and symptoms of tracheal or oesophageal obstruction are common. The cysts usually contain clear, colorless mucoid fluid. The authors describe here a successfully treated enteric cyst with an unusual, retroperitoneal location, which presented in an adult.     

Thymic cyst presenting as tachy-brady syndrome

Tachy-brady syndrome or sick-sinus syndrome as it is also known is a cardiac rhythm disturbance resulting in alternating episodes of bradycardia and tachycardia. Diagnosis can be difficult because of its nonspecific symptoms and elusive findings on electrocardiogram or 24 h tape. Thymic cysts are relatively uncommon tumours that are predominantly asymptomatic and located in the anterior mediastinum. We present the first known report of tachy-brady syndrome associated with a large thymic cyst. Treatment consisted of dual-chamber pacemaker implantation prior to video-assisted removal of the thymic cyst.     

Parathyroid cysts of the neck and mediastinum. Case report

Five cases of parathyroid cyst are presented and the literature concerning this rare entity is reviewed. Three of the five cysts were located in the neck and were non-functioning. The other two were in the anterior mediastinum and functioning, and indeed were associated with hypercalcemic crisis. Four cases were treated surgically, and in one non-functioning parathyroid cyst both diagnosis and treatment were accomplished with fine-needle aspiration. The cystic appearance, color of the fluid contents, high content of parathyroid hormone and histologic features distinguish parathyroid cyst from the much commoner thyroid cyst. Non-functioning parathyroid cysts can be treated with fine-needle aspiration, whereas functioning cysts require surgical removal.     

Mediastinoscopic resection combined with a sternum lift technique in a case of thymic cyst]

We report on a case of thymic cyst which was successfully treated with mediastinoscopic resection combined with a sternum lift technique. A 62-year-old man was admitted to our hospital with a thymic cyst, which was causing chest discomfort and was increasing in size. The tumor was located above the pulmonary artery in the anterior mediastinum. He underwent mediastinoscopic resection while lifting the inferior portion of the sternum with a Laparolift. The cyst was resected sharply and bluntly with the Harmonic Scalpel without rupture. The patient was discharged on the 6th postoperative day in a good condition. Mediastinoscopic resection of a thymic cyst through a xiphoid approach is a useful surgical approach because of the absence of postoperative pain and because it allows early discharge from the hospital.     

Bronchogenic cyst of the right hemidiaphragm presenting with pleural effusion

Bronchogenic cysts are developmental foregut anomalies usually located within the mediastinum or lung parenchyma. An isolated bronchogenic cyst of the diaphragm is very rare. Our case was a 56-year-old female patient who presented with pleuritic chest pain in her right chest. Chest and abdominal computed tomography revealed a large lobulated cystic mass that was accompanied with pleural effusion in the right lower hemithorax. The tumor showed focally calcified areas in the wall and abutted against the diaphragm. We performed complete excision of the cyst including a portion of the diaphragm attached to it. The pathological diagnosis was established as the bronchogenic cyst originating from the diaphragm. We report this case with a review of the literature.     

Intracardiac bronchogenic cyst

Bronchogenic cysts are congenital malformations that originate from the primitive foregut and are commonly located in the mediastinum or lung. The heart is one of the sites for atypical locations of such cysts. In this report, we describe an intracardiac bronchogenic cyst seen as an incidental finding during patch closure of a ventricular septal defect.     

Hypermetabolic lesion in the prevascular mediastinum – always a thymoma/lymphoma?

Abstract

Cholesterol granuloma is a foreign-body giant cell reaction that can occur in response to the presence of cholesterol crystals. They are usually found in the middle ear, paranasal sinuses or mastoid process due to chronic inflammation. Presentation in the prevascular mediastinum is a rare finding. We describe a case of a cholesterol granuloma located in the prevascular mediastinum in a symptomatic 57-year-old male patient.     

Thymoma with intracystic dissemination arising in a unilocular thymic cyst

A 33-year-old asymptomatic woman was referred to our hospital for evaluation of an abnormal shadow on a chest radiograph. A chest-computed tomogram revealed a cystic, partially solid tumor in the right inferior mediastinum. Following an initial diagnosis of cystic teratoma, surgery was performed. The tumor, a well-encapsulated, thin-walled cyst located within the right inferior lobe of the thymus, was extirpated by partial resection of the thymus. The cut surface revealed a unilocular cyst containing multiple grayish-white tumors on the inner cyst walls. Some tumors detached from the wall owing to loose connections. Microscopic findings revealed that the cyst was lined with squamous epithelium. The tumor on the cyst wall was diagnosed to be a type B1 thymoma. Based on these findings, we diagnosed this case as a thymoma originating from the wall of a thymic cyst, accompanied by intracystic dissemination from the tumor.