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The mediastinum refers to the area located between the left and right lungs, and contains the major blood vessels, trachea, esophagus, and thymus. Tumors that develop in these mediastinal organs are called mediastinal tumors, and include thymus-related tumors, including thymoma, neurogenic tumors, and congenital cysts. Many are asymptomatic benign tumors, often discovered incidentally on CT scans during medical checkups or follow-up or treatment for other illnesses. However, there are also malignant tumors, such as thymic carcinoma and malignant lymphoma. Of these, thymoma is the most common, and its progression ranges from very slow to rapid, making it considered a potentially malignant tumor. Thymoma is also commonly associated with autoimmune diseases, such as myasthenia gravis.
If a tumor is found to have a cell mass (called a solid tumor) on CT or MRI scans, surgical removal of the mediastinal tumor from its original location is recommended, even if it is benign. On the other hand, tumors thought to be congenital cysts, which do not show any cell masses, are monitored for growth or the appearance of cell masses. Surgery is performed using either thoracoscopic or open thoracotomy, taking into consideration the tumor's characteristics and location. In particular, our department has achieved good results with thoracoscopic thymectomy using chest wall lifting for thymus-related tumors, including early-stage thymomas. Even for malignant mediastinal tumors deemed to be progressing, if treatment is deemed effective, we perform open thoracotomy, including the concomitant resection of other organs. For myasthenia gravis, we work closely with the neurology department to prepare for preoperative control of myasthenia gravis and perform extended thymectomy.
