The changing patterns of occurrence and management in primary mediastinal tumors and cysts in the People's Republic of China.

Primary mediastinal tumors and cysts (MTC) constitute a common problem in thoracic operations done in the People's Republic of China. Data from 4,357 instances of MTC diagnosed in China between 1963 and 1985, including 307 from our own facility, are presented. Teratoid tumors are the most common of the MTC in the northern part of China contrasting with thymomas and neurogenic tumors which are the most common in the southern part of China; a finding that notes a significant difference (p less than 0.01). Beyond this, the distribution of MTC is different than in North America. In patients we studied, we were able to predict the correct histopathologic diagnosis 80 per cent of the time by considering the history of the patient and the results of a conventional roentgenogram of the chest. This was increased to 91.4 per cent when needle biopsy was added. Optimal therapy for MTC is complete surgical resection. We present a scheme for localization of the various types of MTC and an operative approach.