Videothoracoscopic excision of mediastinal masses: Indications and technique

Roviaro, Giancarlo; Rebuffat, C.; Varoli, F.; Vergani, Contardo; Maciocco, M.; Scalambra, S.M.

doi:10.1016/0003-4975(94)91658-6

Cited by 104 publications

(46 citation statements)

References 11 publications

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“…Furthermore, successful resections of thymoma invading the right atrium and thymoma invading the right ventricular outflow tract have been reported [24,25]. Although videoassisted resections of completely encapsulated thymoma have been reported with acceptable morbidity, mortality and shortand long-term results are not yet known [26]. In one study, overall five-year prognosis of surgically resected invasive versus noninvasive thymoma was 67% versus 85%, emphasizing that even in cases of complete resection, tumor stage remains an important predictor of long-term survival [8].…”

Section: Surgerymentioning

confidence: 99%

Thymoma: Update for the New Millenium

et al. 2001

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USA. Telephone: 210-616-5648; Fax: 210-949-5085; e-mail: cthomas@saci.org www: cancerdata.com Received October 11, 2000; accepted for publication May 11, 2001. ©AlphaMed Press 1083-7159/2001 INTRODUCTIONThymic tumors are common among anterior mediastinal tumors in adults. The vast majority of thymic lesions are thymoma [1]. Thymoma is relatively unique among tumors in that the prognosis appears to be more closely related to the invasive characteristics seen at operation rather than histological appearance. Indeed, the degree of encapsulation and invasion of adjacent tissues define malignancy for these tumors rather than the histologic appearance of the tumor cells [2]. Current treatment of thymoma is often multidisciplinary in nature, and has evolved based upon a growing number of studies to date. These studies have looked at various outcomes based upon associated patient syndromes, tumor histology, and tumor staging, as well as various surgical, radiotherapeutic, chemotherapeutic, and multimodality trials. These studies form the basis of this review.

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Section: Surgerymentioning

confidence: 99%

Thymoma: Update for the New Millenium

et al. 2001

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“…Thymus biopsy by videothoracoscopy can be an alternative, although it has not been reported in literature in the same context of our case, and there have been very few reports in other situations. There are reports of the successful use of videothoracoscopy in the excision of mediastinum lesions and thymectomy; it is, however, an invasive procedure that presents morbidity (post-surgical bleeding, for instance) (27,28).…”

Section: Discussionmentioning

confidence: 99%

Thymus hyperplasia after resolution of hypercortisolism in ACTH-dependent Cushing’s syndrome: the importance of thymic vein catheterization

Neto

Machado²,

Mesquita³

et al. 2006

eur j endocrinol

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Thymic hyperplasia has been described after the resolution of hypercortisolism from several etiologies, causing great diagnostic dilemmas. We describe a case where the catheterization of the thymic vein was essential for the differential diagnosis of a thymic enlargement in an adrenalectomized patient with ACTH-dependent Cushing's syndrome. The patient was a 48-year-old female with clinical and laboratorial data suggesting Cushing's disease. She underwent a transsphenoidal surgery with no tumor visualization and no remission of the syndrome. Histopathological studies disclosed a normal pituitary. She underwent a bilateral adrenalectomy and 8 months later a chest CT showed an increase of left thymic lobe, which was previously non-existent. After a negative 111 In-pentetreotide scintigraphy, the patient underwent simultaneous and bilateral catheterism of the petrosus sinuses and catheterization of the thymic and inominate veins and no ACTH gradient was shown among the sites of collection. She did not undergo thoracotomy and a follow-up was established. During the evolution, there was a spontaneous regression of the thymic lesion 38 months after the diagnosis. The ACTH gradient during the catheterization of thymic vein was essential for the differential diagnosis of the thymic enlargement tumor after hypercortisolism resolution in ACTH-dependent Cushing's syndrome, especially in this case, where the ACTH source was occult, thus avoiding an invasive surgical procedure for a benign entity with spontaneous resolution.European Journal of Endocrinology 154 807-811

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“…Malignant mediastinal lesions currently are considered a contraindication for endoscopic removal [2,9]. However, with confirmed benign histology, we believed that continuing with the minimally invasive approach was a reasonable option.…”

Section: Figmentioning

confidence: 99%

“…tive information for the diagnosis and treatment of mediastinal lesions [9]. However, a posterior mediastinal mass rarely may mimic an adrenal tumor on CT scan, and the patient may be prepared for adrenal surgery with the real diagnosis made intraoperatively.…”

Section: Figmentioning

confidence: 99%

Erratum

et al. 2001

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Background: Rarely, a posterior mediastinal mass may mimic an adrenal tumor on preoperative computed tomography scan. The intraoperative discovery that a mass thought to be associated with the adrenal gland actually is above the diaphragm in the posteroinferior mediastinum poses a challenge for the laparoscopic surgeon. Conversion to a thoracotomy or to videothoracoscopy incurs additional morbidity and risk for the patient. Materials and Methods: We describe a technique for the transdiaphragmatic removal of a benign mass from the posterior mediastinum. A posterior mediastinal tumor was detected during a laparoscopic procedure for a suspected right adrenal tumor. Frozen section proved benign, and the mass was resected laparoscopically via transdiaphragmatic access to the posterior mediastinum. Results: No complications were noted during or after surgery. The patient was ready for discharge from the hospital on postoperative day 1. Conclusions: Transdiaphragmatic resection was done successfully instead of conversion to a thoracotomy or thoracoscopic procedure for a benign posterior mediastinal tumor found incidentally during laparoscopic surgery for a presumed adrenal lesion. This transdiaphragmatic approach can be applied to selected benign mediastinal masses.

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Videothoracoscopic excision of mediastinal masses: Indications and technique

Cited by 104 publications

References 11 publications

Thymoma: Update for the New Millenium

Thymoma: Update for the New Millenium

Thymus hyperplasia after resolution of hypercortisolism in ACTH-dependent Cushing’s syndrome: the importance of thymic vein catheterization

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