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PRESENTATION OF PRIMARY MEDIASTINAL MASSES IN IBADAN
Abstract
ABSTRACT
Objective: To determine clinical features, anatomic location and histological types of primary
mediastinal masses diagnosed and treated in a black African population.
Design: A retrospective study of clinical data collected from patients case notes, the
cardiothoracic unit’s and pathology records between June 1975 and May 1999.
Setting: University College Hospital, Ibadan, Nigeria which hosts a major cancer center in
the West African sub-region, and serves community clinics.
Patients: All patients with primary mediastinal masses referred for evaluation and treatment.
Main outcome measures: Excluded metastatic, oesophageal and vascular- lesions. All patients
had radiological evalulation and tissue biopsies. The anatomic subdivision of the mediastinum
into anterosuperior, middle and posterior section was used.
Results: One hundred and five consecutive patients were evaluated and treated. The mean
age was 34.0 ± 20.4 years. There were 75 males and 30 females. Eighty one (77.1%) were
symptomatic, 24 (22.9%) were asymptomatic. Thirty seven (45.7%) of the symptomatic
patients had malignant disease while 44 (54.3%) had benign disease. Forty five patients
(43%) and 60 patients (57%) had malignant and benign diseases respectively. Incidence of
symptoms, was 82.2% for malignant and 73.3% for benign diseases. This difference in
incidences is statistically insignificant (p=0.283). Majority of asymptomatic patients (70.8%)
had benign disease while 29.2% of patients with malignancy were asymptomatic. This
difference in incidence was statistically significant (p=0.0039). The frequency of mediastinal
masses were anterosuperior, in 67 patients (63.8%), posterior mediastinal, 24 patients
(22.9%) and middle mediastinal in 14 patients (13.3%). Lymphoma 23 (21.9%), thymus
glands tumours 19 (18.1%) and endocrine tumours (goiters) 18 (17.1%) were the commonest
types of primary mediastinal masses treated.
Conclusion: Majority of our patients with mediastinal masses (whether benign or malignant)
are symptomatic and the absence of symptoms is more associated with benign disease.
Majority of lesions are situated in the anterosuperior mediastinum. Lymphoma is the most
frequent primary mediastinal mass.
Objective: To determine clinical features, anatomic location and histological types of primary
mediastinal masses diagnosed and treated in a black African population.
Design: A retrospective study of clinical data collected from patients case notes, the
cardiothoracic unit’s and pathology records between June 1975 and May 1999.
Setting: University College Hospital, Ibadan, Nigeria which hosts a major cancer center in
the West African sub-region, and serves community clinics.
Patients: All patients with primary mediastinal masses referred for evaluation and treatment.
Main outcome measures: Excluded metastatic, oesophageal and vascular- lesions. All patients
had radiological evalulation and tissue biopsies. The anatomic subdivision of the mediastinum
into anterosuperior, middle and posterior section was used.
Results: One hundred and five consecutive patients were evaluated and treated. The mean
age was 34.0 ± 20.4 years. There were 75 males and 30 females. Eighty one (77.1%) were
symptomatic, 24 (22.9%) were asymptomatic. Thirty seven (45.7%) of the symptomatic
patients had malignant disease while 44 (54.3%) had benign disease. Forty five patients
(43%) and 60 patients (57%) had malignant and benign diseases respectively. Incidence of
symptoms, was 82.2% for malignant and 73.3% for benign diseases. This difference in
incidences is statistically insignificant (p=0.283). Majority of asymptomatic patients (70.8%)
had benign disease while 29.2% of patients with malignancy were asymptomatic. This
difference in incidence was statistically significant (p=0.0039). The frequency of mediastinal
masses were anterosuperior, in 67 patients (63.8%), posterior mediastinal, 24 patients
(22.9%) and middle mediastinal in 14 patients (13.3%). Lymphoma 23 (21.9%), thymus
glands tumours 19 (18.1%) and endocrine tumours (goiters) 18 (17.1%) were the commonest
types of primary mediastinal masses treated.
Conclusion: Majority of our patients with mediastinal masses (whether benign or malignant)
are symptomatic and the absence of symptoms is more associated with benign disease.
Majority of lesions are situated in the anterosuperior mediastinum. Lymphoma is the most
frequent primary mediastinal mass.
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