How to Treat a Mediastinal Cyst

A mediastinal cyst includes many bodies and processes because the mediastinum is adjacent to a wide variety of tissue. These masses are classified according to specific location on the mediastinum: anterior, middle and posterior. The most common origins of mediastinal cysts are germ cells, and lymphatic and thymic tissue. Other types include parathyroid and thyroid tissue, with bronchogenic cysts occurring occasionally. The following steps will show how to treat a mediastinal cyst.

Instructions

• 1

  Perform surgery as the treatment of choice for most mediastinal cysts. Foregut, gastroenteric and neurenteric cysts should be resected, including the entire cyst wall. A complete resection is usually possible even when the cyst adheres to adjacent structures such as the bronchi or esophagus.

• 2

  Remove the mucosal lining from the cyst wall if a complete resection is not possible to prevent the mediastinal cyst from recurring. Cysts of lymphatic or thoracic duct tissue should always be resected and ligated from the thoracic duct.

• 3

  Prepare for the surgery as usual for chest cases. Airway management is critical for tumors that may compress structures involved with respiration. The airway should be assessed in detail with supplementary equipment readily available.

• 4

  Position the patient according to the specific procedure. Cysts in the anterior mediastinum should be approached through a median sternotomy. Cysts of the middle and posterior mediastinum can be accessed through a posterolateral thoracotomy.

• 5

  Resect bronchogenic cysts in infants with severe airway obstruction, if needed. A few cases will require special techniques to deliver anesthesia and oxygen.