Traibi A, El Hammoumi M, El Oueriachi F, Arsalane A, Kabiri E H
Service de chirurgie thoracique, faculté de médecine et de pharmacie de Rabat, université Mohamed V Souissi, hôpital militaire d'instruction Mohamed V, Hay Riad, Rabat, Morocco.
Rev Mal Respir. 2012 Nov;29(9):1111-5. doi: 10.1016/j.rmr.2011.09.053. Epub 2012 Sep 28.
Benign cystic mediastinal mass form a group of heterogeneous and uncommon lesions. Surgical resection is the gold standard in these conditions. We reported our institutional experience in management of these benign tumours. In this review, cardiac and ganglionary benign mass were excluded.
We retrospectively reviewed the records of 28 patients with benign cysts of the mediastinum, who are operated in our department between January 2003 and December 2009 (7years period).
There were 13 females (46.4%) and 15 males (53.5%), with a mean age of 36.8years (range: 13-63years). Most lesions (n=22) were equally in the anterior and middle mediastinum, only six were in the posterior mediastinum. Seventeen patients (60.7%) were symptomatic, with chest pain and cough as the most common symptoms. The diagnosis of mediastinal cyst was fortuitous in 11 patients with the waning of an assessment made for another reason. Surgery was indicated in all patients in order to both diagnostic and therapeutic. Posterolateral thoracotomy incision is the most common. Complete resection of the cyst was possible only in 18 cases (64.3%), whereas in ten (35. 7%) other cases part of the cyst was left in place due to tight adhesions to vital structures. After histological study, there were: nine bronchogenic cysts (32.1%), seven hydatid cysts (25%), four cystic lymphangiomas (14.3%), three mature cystic teratomas (10.7%) and three pleuropericardial cysts, one thymic cyst and one parathyroid cyst. The postoperative course was uneventful and no recurrence has been observed until now.
The benign cysts of the mediastinum is a rare entity, the hydatid etiology remains common in our context. Surgical treatment remains the treatment of choice for mediastinal cysts, when the patient is operable, to save the risk of complications or degeneration.
纵隔良性囊性肿块是一组异质性且不常见的病变。手术切除是这些情况下的金标准。我们报告了我们机构在这些良性肿瘤管理方面的经验。在本综述中,排除了心脏和神经节良性肿块。
我们回顾性分析了2003年1月至2009年12月(7年期间)在我们科室接受手术的28例纵隔良性囊肿患者的记录。
有13名女性(46.4%)和(53.5%)15名男性,平均年龄为36.8岁(范围:13 - 63岁)。大多数病变(n = 22)在前纵隔和中纵隔中分布均匀,只有6个位于后纵隔。17名患者(60.7%)有症状,胸痛和咳嗽是最常见的症状。11名患者在因其他原因进行评估时偶然发现纵隔囊肿。所有患者均需进行手术以进行诊断和治疗。后外侧开胸切口最为常见。仅18例(64.3%)能够完整切除囊肿,而在其他10例(35.7%)中,由于与重要结构紧密粘连,部分囊肿留在原位。组织学检查后发现:9例支气管源性囊肿(32.1%)、7例包虫囊肿(25%)、4例囊性淋巴管瘤(14.3%)、3例成熟囊性畸胎瘤(10.7%)以及3例胸膜心包囊肿、1例胸腺囊肿和1例甲状旁腺囊肿。术后过程顺利,至今未观察到复发。
纵隔良性囊肿是一种罕见的疾病,在我们的环境中包虫病因仍然常见。当患者可进行手术时,手术治疗仍然是纵隔囊肿的首选治疗方法,以避免并发症或退变的风险。