SURGICAL MANAGEMENT OF ANTERIOR MEDIASTINAL MASSES

Abstract

Diseases of the mediastinum comprise a wide spectrum of benign and malignant entities that share the same anatomical location within the chest. The mediastinum is traditionally divided into three compartments: anterior, middle and posterior. This division, which is based on the lateral chest X-ray, allows a rational, topographic approach to the differential diagnosis and helps plan further imaging studies and clinical investigations to select the definitive cytohistological procedure and the most appropriate treatment strategy. Several anatomical and radiological classifications of the mediastinum are reported in the literature. Knowledge of pathology, demographics, clinical presentations, imaging patterns and treatment options is indispensable for correct management of anterior mediastinal masses, which often require a multidisciplinary approach. In particular, with the improvement of imaging techniques in orienting diagnosis and guiding biopsy procedures, most patients no longer require exploratory thoracotomy before treatment planning.