Clinical features, diagnosis and thoracoscopic surgical treatment of thymic cysts

Wang, Xun; Xiao, Li; Li, Yun; Yang, Fan; Li, Jianfeng; Jiang, Guanchao; Li, Jun; Wang, Jun

doi:10.21037/jtd.2017.10.148

Cited by 33 publications

(36 citation statements)

References 17 publications

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“…Since that time, VATS has been increasingly adopted to treat various mediastinal cysts. 2,[12][13][14][15] Guo and colleagues 16 compared VATS versus traditional thoracotomy in patients undergoing surgical resection of PMCs and confirmed that VATS could reduce the operative duration and intraoperative blood loss without increasing the risks of incomplete resection and intraoperative and postoperative complications. In our series, VATS was initially performed for all patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and management of primary mediastinal cysts: A single‐center experience

Wang

Yang

et al. 2020

Thoracic Cancer

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Background In this study we aimed to assess the clinical outcomes of performing video‐assisted thoracic surgery (VATS) to treat primary mediastinal cysts (PMCs) and investigate the clinical factors which increase the difficulties associated with VATS. Methods The medical records of all consecutive PMC patients, who underwent surgical resection from April 2001 to July 2016, were reviewed and 282 patients were included. Clinical characteristics, imaging features, and surgical outcomes were analyzed. Follow‐up data were successfully obtained from 230 PMC patients by telephone or outpatient clinic annually. The latest follow‐up was July 2019. Results VATS was performed in 278 patients and four patients were converted into thoracotomy. The mean operation time and intraoperative bleeding were 102.4 ± 40.9 minutes (range 25–360 minutes) and 52.4 ± 75.1 mL (range 5–600 mL), respectively. The intra‐ and postoperative complication rates were 2.8 and 5.7%, respectively. Seven patients with bronchogenic cysts showed severe cyst adhesion to vital mediastinal structures and thus had incomplete resection. Multivariable logistic analysis revealed that a maximal cyst diameter greater than 5 cm was significantly associated with increased risks of operation time extension (OR = 2.106; 95% CI: 1.147–3.865, P = 0.016) and intraoperative blood loss increase (OR = 4.428; 95% CI: 1.243–16.489, P = 0.022). A total of 230 patients had follow‐up data. The median follow‐up time was 70 months (range, 36–210 months). No local recurrence was observed. Conclusions Surgical resection by VATS may be recommended for PMC management as a primary therapeutic strategy. Cysts with a maximum diameter greater than 5 cm or cysts adjacent to vital mediastinal structures can increase the surgical difficulties. Key points • Significant findings of the study A diameter >5 cm and adhesions significantly increased the risk of operation time extension together with increased blood loss. • What this study adds Cysts with a diameter >5 cm or those adjacent to vital mediastinal structures increased the potential for surgical difficulties.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics and management of primary mediastinal cysts: A single‐center experience

Wang

Yang

et al. 2020

Thoracic Cancer

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“…In the present study, 76 cases (64%) were found on physical examination and had no symptoms, while 42 cases (36%) were symptomatic, of which, 23 cases (19%) complained of respiratory symptoms and 16 cases (13%) complained of chest pain. Wang et al reported that among 108 thymic cysts, 70% cases were asymptomatic, 25% cases had respiratory symptoms, and 5% cases had chest pain [ 7 ]. Our results are in line with their study.…”

Section: Discussionmentioning

confidence: 99%

“…Most studies reported that the average diameter of surgically resected thymic cysts was in the range of 1.5–2.5 cm [ 2 , 4 , 6 , 8 ]. Wang et al reported that the average size of the 108 surgery-resected thymic cysts was 48.3±33.7 mm at the largest diameter (range, 5–160 mm) and the average size of the retrosternal thymic cysts was 22±8 mm [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

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Clinical Experience with Thymic Cystectomy: A Single-Institution Study of 117 Cases from 2013 to 2019

Wang

Zhang

et al. 2020

Med Sci Monit

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Background The aim of this study was to summarize the clinical experience of thymic cysts treatment from a single center. Material/Methods Clinical data, imaging, pathological results, and follow-up results of thymic cyst patients who underwent surgery from January 2013 to September 2019 were retrospectively reviewed. Results A total of 117 patients were enrolled, including 76 asymptomatic patients and 41 symptomatic patients. The average diameter of thymic cysts, the cysts in asymptomatic patients, and those in symptomatic patients were 31.93±19.92 mm, 29.28±17.97 mm, and 36.85±22.50 mm, respectively. The number of cysts ranged from 1 to 3 cm, 3 to 6 cm, and >6 cm in 73 cases (62.4%), 32 cases (27.3%), and 12 cases (10.3%), respectively. There was no correlation between the size of thymic cysts and the presence or absence of symptoms. Only 20 cases (17.1%) were correctly diagnosed as thymic cysts before surgery. There were 67 patients (57.3%) who underwent video-assisted thoracic surgery (VATS) and 50 cases (42.7%) underwent open surgery. Cystectomy was performed in 93 cases (79.5%) and 24 cases (20.5%) underwent simultaneous resection of thymic cysts and other thoracic tumors. Compared with the thoracotomy group, the VATS group had shorter hospital stay and chest tube indwelling time. No serious complications occurred after surgery. The median follow-up time was 45.0 months (range 4.0–84.0 months) and there was no recurrence. Conclusions Attention should be paid to the accuracy of preoperative diagnosis of thymic cysts and the reduction of asymptomatic thymic cystectomy. For patients who have both thymic cysts and other thoracic tumors, simultaneous surgery is safe and feasible.

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“…Teško je razlikovati ciste od solidnih tumora timusa kod nekih pacijenata i preoperativna dijagnostika uglavnom zavisi od radio-imidžing tehnika 12 . Tako je bilo i sa našim pacijentom.…”

Section: Diskusijaunclassified

Thymic cyst as a diagnostic challenge

Knežević¹,

Srećković²,

Vulović³

2019

Med gl Spec bol štit Zlatibor

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Sažetak: Uvod. Ciste timusa su retke, benigne, većinom kongenitalne anomalije i predstavljaju 1-3% svih medijastinalnih masa, najčešće u prednjem medijastinumu. Mogu biti kongenitalne ili stečene, u sklopu različitih imunoloških i malignih bolesti. Oko 60% pacijenata sa cistama timusa je asimptomatsko, a ukoliko postoje simptomi nisu specifični već su to kašalj, dispnoja i bol u grudima. Prikaz bolesnika. Pacijent star 48 godina, u martu 2018. godine dolazi na pregled zbog visoke temperature, upornog suvog kašlja i krvi u ispljuvku. Radiografija i kompjuterizovana tomografija pokazale jasno ograničenu promenu desno paratrahealno, promera 64x53 mm, jasnih ivica, bez invazije i kontinuiteta u okolno tkivo. Inicijalna bronhoskopija ukazala na kompresiju traheje, a drugom je eksplorisano sedam limfnih žlezda sa nespecifičnim nalazom kada je dobijeno i pet mililitara žućkastog tečnog sadržaja. U međuvremenu, kod pacijenta prestaju znaci respiratorne infekcije, kašalj i iskašljavanje sukrvice krvi, takođe i dobro se osećao. Video-asistiranom torakoskopskom hirurgijom učinjena je kompletna resekcija promene uz očuvanje timusa. Promena je bila jasno ograničena od okoline, inkapsulirana, tankog zida. Patohistološki nisu nađene maligne ćelije, zid se sastojao od fibroznog cističnog tkiva sa fragmentima timusnog tkiva. Radilo se o benignoj, prostoj, kongenitalnoj timusnoj cisti. Zaključak. Svakog pacijenta sa sumnjom na cistu timusa uputiti na multidisciplinarni tim sa iskustvom u medijastinalnoj patologiji. Hirurška resekcija kod našeg pacijenta sprovedena je u dijagnostičke i terapijske svrhe. Ključne reči. Medijastinum, torakoskopska hirurgija, timusna cista. THYMIC CYST AS A DIAGNOSTIC CHALLENGE Introduction. Thymic cysts are rare, benign, mostly congenital anomalies and represent 1-3% of all mediastinal masses, most frequently found in the front mediastinum. They can be congenital or acquired, as part of

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Clinical features, diagnosis and thoracoscopic surgical treatment of thymic cysts

Cited by 33 publications

References 17 publications

Clinical characteristics and management of primary mediastinal cysts: A single‐center experience

Clinical characteristics and management of primary mediastinal cysts: A single‐center experience

Clinical Experience with Thymic Cystectomy: A Single-Institution Study of 117 Cases from 2013 to 2019

Thymic cyst as a diagnostic challenge

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