Osman Korcan TİLKAN, İsmail Cüneyt KURUL, Özgür KARAKURT, Sedat DEMİRCAN

Bir Üniversite hastanesi kliniği olguları eşliğinde mediastinal kitle ve kistlere bakış

Amaç: Mediasten, iki torasik kavite arasında yer alan ve içerdiği doku çeşitliliği, kanlanmasının iyi olması, lenfatik doku zenginliği nedeniyle birçok primer ve sekonder kitle, kistin yerleştiği vücut kompartmanıdır. Çalışmamızda mediastinal kitle ve kistlerin tanı, tedavisinde cerrahinin yeri ve önemi araştırıldı. Gereç ve Yöntem: Anabilim Dalımızda Temmuz 2002 Temmuz 2009 tarihleri arasında primer mediastinal kitle ve kist nedeniyle takip edilen 86 olgu yaş, cinsiyet, şikayet, lezyon lokalizasyonu, girişim yolu, yapılan rezeksiyon ve histopatolojik tanı açısından retrospektif olarak değerlendirildi. Bulgular: Primer mediastinal kitle tanısıyla çalışmaya dahil edilen 44 (%51)ü kadın 86 olgunun yaşları 5- 78 arasında, ortalama yaşları 41.03 idi. Olgularımızda en sık (% 50) anterior mediastende lezyon saptandı. İncelediğimiz vakaların 37sinde (%43) semptom yoktu, en çok görülen şikayetler göğüs ağrısı (%26.7), öksürük (%23.5) ve nefes darlığı (%17.6) idi. Hastaların hepsinde cerrahi yöntemlerle; sağ/sol torakotomi(%41.9/%10.5), median sternotomi (%25.6) veya mediastinoskopi (%4.7) ile tanıya ulaşıldı. Tartışma: Mediastinal kitle ve kistlerin tanısında lezyon lokalizasyonu ve klinik bulgular her ne kadar yardımıcı olsa da kesin tanı içi hitopatolojik değerlendirme vazgeçilmezdir. Doğru histopatolojik değerlendirme için yeterli materyal örneklenmesi ve birçok lezyonun spesifik tedavisi için mediastinal kitlelerde cerrahi halen en önemli tanısal ve terapötik modalitedir.

Primary mediastinal tumors and cysts: Perspective of a University hospital

Aim: Mediastinum is the body compartment between two thoracic cavities. Due to its rich tissue variability, vascularity and lymphatic tissue content, mediastinum is a place for primary and secondary masses and cysts. In this study, the role of surgery for the diagnosis and treatment of mediastinal tumors and cysts, were investigated. Method: Eighty six patients who admitted to our clinic with diagnosis of primary mediastinal cysts and tumors between July 2002 and July 2009 were investigated. All of the patient were analysed retrospectively for age, gender, complaint, lesion localization, surgical procedure and histopathological diagnosis. Result: Tumor- cyst excision was performed for primary mediastinal masses in 86 patients. There were 44 (51 %) women and 42 (49%) men, aged from 5 to 78 ( mean age was 48,03). Most of the lesions were located in the anterior mediastinum (50%). Thirty seven of the cases did not have any complaints. Chest pain (26.7%), cough (23.5%) and shortness of breath were common complaints. Definitive diagnosis was obtained in all of the patients by right/left thoracotomy (41.9%/10.5%), sternotomy (25.6%) or mediastinoscopy (4.7%). Discussion: Although lession location and clinical findings are helpful in determination of mediastinal cysts and tumors, tissue diagnosis is almost always required. Surgery is compulsory for adequate tissue sampling and it is stil the most important therapautic procedure.

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