Pitfalls in Diagnosis of Mediastinal Tumors

Evaluation of 100 Cases

¹ Tel-Hashomer, Israel
² Department of Thoracic and Cardiovascular Surgery, Tel-Hashomer Government Hospital
³ Head of the Department

1. The presence or absence of symptoms was no indication of the nature of the disease. In 18 per cent of the patients in whom the tumor was discovered accidentally, it proved to be malignant. This is approximately the same proportion as in patients who did have various symptoms (Table 2).

[See table in the PDF file]

2. The nature of the pathologic lesion is often assumed from its location. In 8 per cent the tumor could not be so diagnosed. If all cystic lesions are included from all portions of the mediastinum, the proportion of errors is increased four-fold.

3. Evidence of superior vena cava obstruction, neurologic abnormalities or expansion of the tumors on both sides of the mediastinum do not afford reliable guides to the nature of the tumor or its resectability.

4. It is evident that benign tumors, even with histologic confirmation, do not warrant conservative management in view of the risk of malignant change.

5. Neither clinical symptomatology nor radiologic and other ancillary diagnostic means provide absolute diagnostic certainty. Both diagnosis and, in most cases, definite therapy, require exploration.