Clinicopathological Spectrum of Mediastinal Masses: A Single-Center Experience.

Abstract

Background

Mediastinal masses comprise a heterogeneous group of benign and malignant lesions arising from different mediastinal compartments. Their clinical presentation, radiological appearance, and histopathological spectrum vary widely according to age and anatomical location. Evaluating the clinicopathological pattern of mediastinal masses is essential for accurate diagnosis, timely management, and improved patient outcomes.

Objectives

To assess the clinical presentation, anatomical distribution, histopathological spectrum, and postoperative outcomes of mediastinal masses in patients managed at a single tertiary care center.

Methodology

This retrospective descriptive study was conducted at Department of Thoracic Surgery Unit, Lady Reading Hospital  Medical Teaching Institution, Peshawar from jan 2019 to jan 2020. A total of 72 patients diagnosed with mediastinal masses during the study period were included. Demographic characteristics, presenting symptoms, radiological location of the mass, histopathological diagnosis, type of surgical or diagnostic procedure, postoperative complications, hospital stay, and mortality were recorded using a structured data collection form. Data were analyzed using SPSS version 24. Continuous variables were expressed as mean ± standard deviation, while categorical variables were presented as frequencies and percentages. Statistical significance was set at p < 0.05.

Results

A total of 72 patients were included in the study. The mean age of the patients was 42.7 ± 16.4 years, and males constituted 58.3% of the study population. The most common presenting symptoms were chest pain (24 patients, 33.3%), cough (20 patients, 27.8%), dyspnea (13 patients, 18.1%), and incidental radiological detection (9 patients, 12.5%). The anterior mediastinum was the most frequent site of involvement (37 patients, 51.4%), followed by the posterior mediastinum (19 patients, 26.4%) and middle mediastinum (16 patients, 22.2%). The most common histopathological diagnosis was thymic lesions (17 patients, 23.6%), followed by lymphoma (13 patients, 18.1%), neurogenic tumors (12 patients, 16.7%), germ cell tumors (10 patients, 13.9%), mediastinal cysts (9 patients, 12.5%), and metastatic or other lesions (11 patients, 15.3%). Postoperative complications were observed in 10 patients (13.9%), with wound infection and prolonged air leak being the most common. The mean hospital stay was 6.8 ± 2.9 days, and overall mortality was 1 patient (1.4%).

Conclusion

Mediastinal masses demonstrate a wide clinicopathological spectrum, with anterior mediastinal lesions being the most common. Thymic lesions, lymphoma, and neurogenic tumors represented the leading histopathological diagnoses in this series. Histopathological confirmation remains essential for appropriate diagnosis and management. Most patients had acceptable postoperative outcomes with low mortality.