Approaches and Surgical Techniques for Anterior Mediastinal Pathology

Abstract

The anterior mediastinum is the most common location of mediastinal masses . Although various types of pathological lesions may arise there, the most common are thymic malignancies followed by lymphomas . All lesions require cross-imaging studies, preferably contrast-enhanced multidetector computed tomography . Serum tumour markers may be helpful in establishing a diagnosis . When diagnosis is difficult, when upfront curative surgery cannot be undertaken due to the infiltrative nature of the lesion, or when treatment of the lesion is non-surgical, tissue biopsy is required. A typical approach for surgical biopsy is anterior mediastinotomy or video-assisted thoracic surgery . When curative surgery is to be performed, median sternotomy or one of a broad spectrum of minimally invasive approaches is usually utilized.