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 1 January 2017 to 31 December 2020. The aim of this study is to show the points of agreement and the points of disagreement with other studies over the world that dealwith mediastinal masses from the aspects of incidance, clinical diagnostic procedures, surgical management, and outcomes.

The total number of patients studied was 60, including 33 males and 27 females. Twenty-one patients (13 male, 8 female)were excluded from our study for a variety of causes. The remaining 39 (20 male, 19 female) patients 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 15 patients (25%) followed by lymphomas comprising 12 patients (20%). Males and females were similarly represented (51.2% vs

48.8%) The most common age group in our study was the fourth decade of life (10 patients; 25.6%) followed by the 3rd and 5th decades (7 patients; 17.9%). Ages ranged from 12 to 68 years, and averaged 40 years.

The most common symptom was chest pain with 10 patients(25.6%) followed by dyspnea with 9 patients (23%) ,and the most common systemic effects of the mediastinal masses were myasthenia gravis and SVC obstruction with 4 patients for each (10.3%), followed by tracheal compression with 3 patients (7.7%).

The most common surgical procedure done for our patients was total resection in 18 patients (46.2%) followed by tissue sampling and staging procedure in which 11 patients (28.2%) were involved. The most common histopathology results were benign with 35 ( 89.7%) of patients and the remaining 4 patients (10.3%)had malignant disease.

In conclusion, mediastinal masses are a common surgical problem all over the 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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