title: Single institutional experience with primary mediastinal cysts: clinicopathological study of 108 resected cases.
abstract: OBJECTIVE
  To review our institutional surgical outcomes with primary mediastinal cysts (PMCs) and elucidate the clinicopathological differences among several histological PMC variants.
  
  
  METHODS
  We retrospectively reviewed 108 patients who underwent surgery for PMC at our institution between 1997 and 2012.
  
  
  RESULTS
  There were 54 thymic cysts (TCs), 26 bronchogenic cysts (BCs), 16 mature cystic teratomas (MCTs), 11 pericardial cysts (PCs), and 1 esophageal duplication cyst. Surgical approach was via thoracoscopy in 44, thoracotomy in 24, median sternotomy in 39, and hemiclamshell incision in 1. Pathological complete resection was achieved in all patients. Postoperative complications occurred in 13 patients. There was no postoperative mortality. All patients were recurrence-free after a mean follow up of 41 ± 26 months. MCT was significantly associated with larger cyst size (p <0.001) more frequent combined resection of invaded organs (p <0.001), more intraoperative bleeding (p = 0.005), and longer duration of operation (p = 0.022) than the 3 other groups (TC, BC, and PC).
  
  
  CONCLUSIONS
  Surgical treatment for PMC is safe and efficacious regardless of approach. Patients with MCT may require more aggressive surgeries than those with other histological variants, reflecting their potential for invasion into surrounding structures and larger cyst size.
authors.affiliation: Division of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Kozu
authors.forename: Kenji
authors.initials: K
authors.lastname: Suzuki
authors.forename: Shiaki
authors.initials: S
authors.lastname: Oh
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsunaga
authors.forename: Yukio
authors.initials: Y
authors.lastname: Tsushima
authors.forename: Kazuya
authors.initials: K
authors.lastname: Takamochi
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D001994:Bronchogenic Cyst / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D004934:Esophageal Cyst / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008476:Mediastinal Cyst / Q000473:pathology / Q000601:surgery*; D008479:Mediastinal Neoplasms / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000473:pathology / Q000601:surgery*; D061646:Operative Time; D012189:Retrospective Studies; D012307:Risk Factors; D056346:Sternotomy / Q000009:adverse effects; D013724:Teratoma / Q000473:pathology / Q000601:surgery*; D013906:Thoracoscopy / Q000009:adverse effects; D013908:Thoracotomy / Q000009:adverse effects; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult