Background: The aim of this study was to evaluate the early results of resection that should be the selected method for the certain diagnosis and radical treatment of mediastinal masses.
Methods: In this retrospective study, we reviewed 53 cases with primary mediastinal tumor and cyst, who were treated surgically between 1984 and 1999, in respect to their age, gender, presenting symptoms, preoperative radiological investigations and surgical technique. There were 29 male and 24 female patients, and their age ranged from 6 to 69 with a mean of 38.2 ± 12.26 years. The most frequent presenting symptoms were chest pain (43%) and cough (15%). Physical examination was normal in majority of patients (58%). Most of the tumors and cysts (43.4%) located in the anterior mediastinum, while others were equally distributed (28.3%) in the middle and posterior mediastinum.
Results: In the tumor group, the most frequent histopathological diagnosis was neurogenic tumors (25%) followed by thymic tumors (19%), teratomas (17%) and lymphomas (9%). Origin of the cysts was bronchogenic in 17%, pericardial in 7% of the patients. Majority of cases (83%) underwent posterolateral toracotomy and complete resection was possible in 49 patients (92%). Partial resection could only be performed in 4%. The biopsies of mediastinal masses were only performed in 4% of patients. Only one patient with malignant thymoma and myastenia gravis died in the early postoperative period.
Conclusion: With low operative mortality rate and high potential for cure, since obtaining definitive diagnosis can often be achieved only on the basis of operative findings and histopathological examination of the gross specimen, surgical resection should be considered first in the management of primary mediastinal tumors and cysts.

Keywords : Mediastinum, tumor, cyst