The Surgical Treatment of Circumscribed Intrathoracic Lesions:

Lesions Found on Routine Thoracic Roentgenologic Examinations, with Absence of Subjective Symptoms

¹ Division of Surgery, Mayo Clinic, Rochester, Minnesota.

The value of routine roentgenograms of the thorax in disclosing the presence of lesions of the thorax in patients who have no subjective symptoms suggesting intrathoracic disease is shown in the foregoing series of 291 various types of extrapulmonary and intrapulmonary lesions which I have treated surgically. In 52 of these cases the patients did not have any symptoms indicating the presence of a lesion.

The most important consideration in this group of 52 cases is that in 12 the lesion was found to be malignant. In nine of these 12 cases the tumors were early primary malignant processes, and surgical removal was achieved at a time when the results of such a procedure are most favorable. Three of the 12 malignant lesions were metastatic, and it is probable that removal will give only a palliative result.

Forty of the 52 symptomless lesions were benign, and removal of them was attained before they had caused any serious injury to surrounding structures or had undergone malignant change.

The importance of a complete clinical examination or, if necessary, exploratory thoracotomy to establish a definite diagnosis and institution of early surgical treatment, is shown by the various types of lesions found in this series of 52 cases of symptomless thoracic tumors: 12, or 23 per cent, of the lesions were malignant.