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The Journal of Thoracic and Cardiovascular Surgery, Vol 87, 295-300, Copyright © 1984 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
GM Graeber, LD Thompson, DJ Cohen, LD Ronnigen, J Jaffin and R Zajtchuk
Between 1965 and 1982, we treated 46 patients with cystic lesions of the
thymus. Thirty patients had anterior mediastinal cysts, nine had cysts
which were large enough to be both cervical and mediastinal, and seven had
cervical cysts. The majority (40/46) presented with asymptomatic masses.
Six patients presented with distinct complaints: dysphagia (four patients),
hoarseness owing to vocal cord paralysis (one patient), and cervical pain
(one patient). All six had benign thymic cysts. The diagnosis of a cystic
mass was established prior to operation by ultrasonography and computed
axial tomography in our last three patients. These two techniques
delineated the capsule and the central fluid in those three cases. All 46
patients had the mass resected without mortality or significant morbidity,
except for resection of the phrenic nerve in one patient with malignant
cystic thymoma. Cervical cysts were excised through cervical incisions.
Cysts located in the anterior mediastinum and cervical-mediastinal cysts
required median sternotomy or right thoracotomy for successful resection.
Pathological examination showed that 39 patients had benign thymic cysts,
three had benign cystic thymoma, two had malignant thymoma, one had a
seminoma arising in the thymus, and one had a lymphoblastoma. We believe
that a cystic thymic mass which can be detected by ultrasonography and
computed tomography, although usually benign, does not eliminate the
possibility of malignancy, and resection, therefore, is indicated.
ARTICLES
Cystic lesion of the thymus. An occasionally malignant cervical and/or anterior mediastinal mass
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