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Factors affecting the preoperative diagnosis of anterior mediastinal cysts

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Abstract

Objective

Although anterior mediastinal cysts are generally benign diseases, the preoperative diagnosis of these lesions is not necessarily accurate. This study aimed to investigate the factors affecting the preoperative diagnosis of anterior mediastinal cysts.

Methods

We conducted a retrospective analysis of 35 patients with pathologically diagnosed anterior mediastinal cysts (20 thymic cysts, 7 bronchogenic cysts, 5 pericardial cysts, and 3 others) that were resected at our hospital and evaluated their preoperative diagnosis, cyst size, and fluid content.

Results

Eighteen, 15, 1, and 1 patient(s) were preoperatively diagnosed with cystic disease, thymoma, thymic cancer, and teratoma, respectively. Cysts were significantly larger in the correct diagnosis group (40.2 ± 18.8 mm) than in the incorrect diagnosis group (21.1 ± 10.4 mm) (p = 0.0011). The cut-off value of the cyst size which separates these groups, as indicated by the receiver operating characteristic curve, was 28 mm, with a sensitivity and specificity of 0.722 and 0.823, respectively. The diagnostic accuracy for mucinous cysts was significantly lower (p < 0.001) than that for serous cysts.

Conclusion

The presence of cysts smaller than 28 mm and mucinous fluid content was possible factors resulting in inaccurate preoperative diagnosis.

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Abbreviations

CT:

Computed tomography

MRI:

Magnetic resonance imaging

FDG-PET:

Fluorodeoxyglucose positron emission tomography

ROC:

Receiver operating characteristic

AUC:

Area under the ROC curve

SD:

Standard deviation

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Conflict of interest

The authors of this manuscript have no conflict of interest to disclose.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-kawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Fumiaki Gochi, Mitsugu Omasa, Tetsu Yamada, Masaaki Sato, Toshi Menju, Akihiro Aoyama, Toshihiko Sato, Fengshi Chen, Makoto Sonobe & Hiroshi Date

Authors
  1. Fumiaki Gochi
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  2. Mitsugu Omasa
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  3. Tetsu Yamada
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  4. Masaaki Sato
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  5. Toshi Menju
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  6. Akihiro Aoyama
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  7. Toshihiko Sato
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  8. Fengshi Chen
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  9. Makoto Sonobe
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  10. Hiroshi Date
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Correspondence to Mitsugu Omasa.

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Gochi, F., Omasa, M., Yamada, T. et al. Factors affecting the preoperative diagnosis of anterior mediastinal cysts. Gen Thorac Cardiovasc Surg 63, 349–353 (2015). https://doi.org/10.1007/s11748-015-0530-2

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  • DOI: https://doi.org/10.1007/s11748-015-0530-2

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