Mediastinal Tumors: Etiology and Surgical Management in Iraq

This is a retrospective study that was performed in the Department of Thoracic and Cardiovascular Surgery, Subspecialty Hospital – Medical City (Baghdad) from January 1, 2017 to December 21, 2020. The aim of this study was to show the points of agreement and disagreement with other studies throughout the world that deal with mediastinal masses from the aspects of incidence, clinical diagnostic procedures, surgical management, and outcomes. 

A total of sixty patients were studied, thirty-three males and twenty-seven females. Twenty-one patients (thirteen male, eight female) were excluded from our study for a variety of causes. The remaining thirty-nine patients (twenty male, nineteen female) were evaluated according to sex, age, symptoms and signs, local and systemic effects of disease, type of surgical procedure, and pathologic results. 

The most common type of mediastinal mass in our study was thymic tumors, present in fifteen patients (25), followed by lymphomas in twelve patients (20%). Males and females were similarly represented (51.2% versus 48.8%). The most common age group in our study was the fourth decade of life (ten patients, or 25.6%), followed by the third and fifth decades (seven patients, or 17.9%, each). Patient ages ranged from twelve to sixty-eight years and averaged forty years. 

The most common symptom was chest pain in ten patients (25.6%), followed by dyspnea in nine patients (23%), and the most common systemic effects of the mediastinal masses were myasthenia gravis and SVC obstruction, which were present in four patients for each (10.3%), followed by tracheal compression in three patients (7.7%). 

The most common surgical procedure performed was total resection in eighteen patients (46.2%), followed by tissue sampling and staging procedure for eleven patients (28.2%). The most common histopathology results were benign in thirty-five patients (89.7%), and the remaining four patients (10.3%) had malignant disease. 

In conclusion, mediastinal masses are a common surgical problem across world, and the results from our study regarding the incidence of sex, age group, symptoms and signs, local and systemic effects of this disease, types of surgical procedures, and the pathologic results were mostly in line with similar studies done in different institutions around the world. 

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