Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Clinical Analysis of Primary Mediastinal Tumors

원발성 종격동 종양의 임상적 고찰

  • 변정욱 (인제대학교 의과대학 서울백병원 흉부외과학교실) ;
  • 조창욱 (인제대학교 의과대학 서울백병원 흉부외과학교실, 인제대학교 의과대학 상계백병원 흉부외과학교실)
  • Published : 1997.01.01
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Abstract

We reviewed 40 cases of primary mediastinal tumors which were operated on at Seoul Paik Hospital from September, 1987 to December, 1995. Of these, 18 were male and 22 were female. The patient ranged in age from 4 years to 68 years with a mean age of 34.1 years. The most common symptoms included chest pain(12.5%), cough(12.5%), dyspnea(7.5%). and palpable neck mass(7.5%), and symptoms were absent at the time of diagnosis in 37.5% of cases. Chest roentgenography and computed tomography(CT) were performed in all patients, and magnetic resonance imaging(MRI) in 5 patients, and transthoracic needle aspiration (TTNA) performed In 22 patients. The sensitivity of TTNA was 72.7%(16 of 22 patients). The lesion was located 60% in the anterosuperior mediastinum, 35% in the posterior mediastinum, and 5% in the middle mediastinum. The primary tumors included thymic neoplasms(11 cases), germ cell tumors(7 cases), neurogenic tumors(10 cases) and a miscellaneous group. The malignant tumors(12.5%) were invasive thymoma(3 cases), spindle cell sarcoma(1 case), and non-Hodgkin's Iymphoma(1 case). A complete excision was done in all 35 benign tumors and 3 malignant tumors. There was no operative mortality, and postoperative complications occurred in 3 cases.

본 인제대학교 의과대학 서을 백병원 흉부외과학교실에서는 1987년 9월 부터 1995년 12월까지 원발성 종격동 종양의 진단하에 수술을 시행한 40례를 대상으로 하여 임상적 고찰을 하였다. 관찰 대상은 남자 18례와 여자 22례로 연령은 Vll에서 68세까지 였으며 평균 )4.1세였다. 종양의 진단시 증상은 흉통(12.5%), 기침(12.5%), 호흡곤란(7.5%) 경부종괴(7.5%), 흉부불쾌감(5.0%) 등이었다. 진단은 모든 예에서 단순 흉부엑스선 사진과 흉부 전산화단층촬영을 실시하였고 5례 에서는 자기공명영상을 시행하였다. 경피적 침생검은 22례에서 시행하여 16례에서 조직학적 진단을 얻었다(민감도 72.7%). 종양의 위치별 분포는 전상부 종격동 24례(60.0%), 후부 종격동 14례(35.0%), 중부 종격동 2례(5.0%)였다. 종양의 종류는 흉선종 11례(27.5%), 신경성종양 10례(25.0%), 배아세포종 7례(17.5%), 낭종 8례(20.0%), 거대 림프 절비대(Castleman's disease) 2례(5.0%), 방추세포육종 1례(2.5%) 그리고 림프종 1례(2.5%), 였다. 악성 종양은 5례로 침습성 흉선종 3례, 방추세포육종 1례, 림프종 1례였다. 치료는 양성의 모든 예와 악성종양 3례에서 완전절제하였고, 2례는 수술이 불가능하였다. 수술후 사망은 없었고 합병증은 창상피열, 성대마비, 어깨강직이 각각 1례씩 있었다.

Keywords

References

  1. Ann Thorac Surg v.44 Primary cysts and neoplasms of the mediastinum: Recent changes in clinical presentation, method of diagnosis, management, and results Davis RD;Oldham HN;Sabiston DC
  2. 대흉외지 v.28 종격동 종양과 낭종의 임상 및 조직학적 고찰 김재련;최형호
  3. J Thorac Cardiovasc Surg v.62 Surgical treatment of mediastinal tumors: A 40-year experience Wychlis AR;Rayne WS;Clagett OT(et al.)
  4. 대흉외지 v.26 종격동 종양의 외과적 고찰 이석재;성숙환;홍종면;서필원;김주현
  5. 대흉외지 v.27 원발성 종격동 종양의 외과적 치료 김종호;오봉석;이동준
  6. 대흉외지 v.27 종격동 종양의 임상적 고찰 고영호;원경준;최덕영;김영진;손동섭;조대윤;양기민
  7. 대흉외지 v.27 원발성 종격동 종양 및 낭종의 임상적 고찰 장기영;임승현;이관선;홍유선;김훈
  8. Ann Thorac Surg v.42 Primary anterior mediastinal tumors in children and adults Mullen B;Richardson JD
  9. J Thorac Cardiovasc Surg v.86 Benign teratomas of the mediastinum Lewis BD;Hurt RD;Payne WS(et al.)
  10. Ann Thorac Surg v.55 Surgical management and radiological characteristics of bronchogenic cysts Suen H;Mathisen DJ;Grillo HC(et al.)
  11. Ann Thorac Surg v.44 congenital esophageal cysts in adults Salo JA;Ala-Kulju KV
  12. Am J Roentgenol v.145 Magnetic resonance imaging of mediastinal and hilar mass: A comparision with CT Levitt RG;Glazer HS;Roer CL(et al.)
  13. Thorac Cardiovac Surgeon v.39 Computed tomography in the pre-operative assessment of mediastinal tumors- Does it improve surgical management? Waller DA;Rees MR
  14. Radiology v.180 Anterior mediastinal masses: Utility of transthorac needle biopsy Herman SJ;Holub RV;Weisbrod GL(et al.)
  15. Cli Chest Med v.8 Percutaneous fine needle biopsy of the mediastinum Weisbrod GL
  16. Ann Thorac Surg v.56 Thoracoscopic diagnosis and treatment of mediastinal masses Kern JA;Daniel TM;Tribble CG(et al.)
  17. J Thorac Cardiovasc Surg v.99 Surgical approach to isolated mediastinal lymphoma Rici C;Rendia EA;Venuta F(et al.)
  18. Ann Thorac Surg v.51 Thymoma: Results of 241 operated cases Maggi G;Casadio C;Cavallo A(et al.)
  19. Ann Thorac Surg v.56 Thoracoscopy in the management of anterior mediastinal masses Sugarbaker DJ
  20. Ann Thorac Surg v.54 Thoracoscopic resection of anterior mediastinal Landreneau RJ;Dowling RD;Castillo WM;Ferson PF
  21. Chest v.4 Thoracoscopic resection of a posterior mediastinal neurogenic tumor Landreneau RJ;Dowling RD;Ferson PF
  22. Cancer v.63 Chemotherapy of invasive thymoma- a retrospective study of 22 cases Goldel N;Boning L;Fredrik A(et al.)
  23. Cancer v.68 Chemotherapy for invasive thymoma: A 13-year experience Fornasiero A;Daniele O;Ghiotto C(et al.)
  24. Radiother Oncol v.19 Role of radiation therapy in locally advanced thymoma Ugeis A;Monetti U;Rossi G(et al. )
  25. Radiother Oncol v.24 Aggressive treatment of intrathoracic recurrences of thymoma Ugesi A;Monetti U;Rossi G(et al.)