Mediastinal mass removal is a surgical procedure used to diagnose, treat or remove abnormal growths located in the mediastinum, the area of the chest between the lungs. These masses may be benign or cancerous and can arise from structures such as the thymus gland, lymph nodes, nerves or connective tissues.
Tampa General Hospital’s cardiothoracic surgeons use advanced surgical techniques to remove mediastinal masses while preserving surrounding structures whenever possible. Procedures are performed at TGH Brooksville, but patients in Brooksville, Spring Hill, Crystal River and surrounding communities have convenient access to consultations, evaluations and follow-up services at multiple locations.
What Is a Mediastinal Mass?
A mediastinal mass is an abnormal growth that develops within the mediastinum, which lies between the lungs, behind the breastbone and in front of the spine. The mediastinum contains the heart, major blood vessels, important structures of the immune system (such as the thymus gland and lymph nodes) and other anatomical components.
Some mediastinal masses are discovered incidentally during imaging studies performed for unrelated reasons, while others cause symptoms such as chest pain, coughing, shortness of breath or difficulty swallowing.
Several types of mediastinal tumors may require surgical removal. Thymomas and other thymic tumors are the most common types. They begin in the thymus gland.
Other common conditions that may require mediastinal tumor surgery include:
- Benign mediastinal masses and cysts
- Germ cell tumors
- Enlarged lymph nodes
In certain cases of lymphoma, when tissue sampling or diagnostic evaluation is required, a biopsy may be performed via the mediastinum. While lymphoma is generally treated with chemotherapy and/or radiation therapy, surgery may occasionally be considered for select patients with a persistent residual mass following treatment.
Because mediastinal masses vary significantly in size and type, a thorough evaluation is necessary to determine the most appropriate treatment approach.
When Is Mediastinal Mass Removal Recommended?
Mediastinal mass removal may be recommended when the growth is causing symptoms, growing over time or suspected to be cancerous. In some cases, surgery is necessary when imaging studies cannot definitively determine the nature of the mass.
Patients may be candidates for mediastinal tumor removal if they have:
- A suspicious or enlarging mediastinal mass
- Symptoms related to compression of nearby structures
- A mass that requires complete removal for treatment
- Diagnostic uncertainty following imaging or biopsy
- Thymic tumors or other mediastinal tumors that are best managed surgically
The decision to proceed with surgery is based on several factors, including the size and location of the mass, the patient's overall health and whether cancer is suspected.
How Is Mediastinal Mass Surgery Performed?
The mediastinal mass removal procedure is tailored to each patient's diagnosis, anatomy and the characteristics of the mass. Our cardiothoracic surgeons carefully select the surgical approach that provides the safest and most effective access while helping achieve the best possible outcome.
When appropriate, mediastinal mass surgery may be performed using video-assisted thoracoscopic surgery (VATS), a minimally invasive technique that utilizes small incisions and specialized instruments guided by a tiny camera. Compared to traditional open surgery (thoracotomy), VATS may offer several advantages, including smaller incisions, less postoperative discomfort, reduced blood loss, shorter hospital stays and a faster recovery. Many patients with select benign or malignant mediastinal masses may be candidates for this minimally invasive approach.
For larger or more complex tumors, a thoracotomy may be necessary. This open surgical technique involves making an incision between the ribs to provide direct access to the mediastinum and surrounding structures. A thoracotomy may be recommended when a tumor involves nearby organs or blood vessels, when complete removal requires greater visibility or when a minimally invasive approach is not appropriate. The surgical team will determine which technique offers the greatest safety and likelihood of successful treatment based on each patient's individual needs.
What Is Recovery Like After Mediastinal Mass Removal?
Recovery following mediastinal surgery depends on the extent of the procedure and the patient's overall health. Most patients spend time in the hospital after surgery so their recovery can be closely monitored.
Patients can typically expect:
- Pain management and supportive care
- Encouragement to walk and gradually increase activity
- Breathing exercises to support lung function
- Follow-up visits to review pathology results and healing progress
Patients who undergo VATS often experience a shorter hospital stay and faster recovery compared to those who require a thoracotomy. While recovery timelines vary, most patients can gradually return to normal activities as healing progresses and their surgeon provides clearance.
What Are the Risks and Outcomes of Mediastinal Mass Removal?
Like any thoracic surgery, mediastinal mass removal carries certain risks. Potential complications may include bleeding, infection, pneumonia, breathing difficulties or reactions to anesthesia. The risk level varies depending on the size and location of the mass and the complexity of the procedure.
For many patients, surgery provides both a definitive diagnosis and effective treatment. Outcomes following mediastinal tumor removal depend on factors such as the type of mass, whether it is benign or malignant and the completeness of its removal.
Expert Mediastinal Mass Care Close to Home
At Tampa General Hospital, patients undergoing mediastinal mass removal are cared for by an experienced team of cardiothoracic surgeons, pulmonologists, oncologists and rehabilitation specialists who work together to develop individualized treatment plans. Our focus is on delivering expert care that addresses each patient's diagnosis, overall health and long-term goals.
Affiliated with USF Health, Tampa General is Florida’s premier academic health system, offering advanced thoracic surgical expertise at TGH Brooksville, along with access to innovative treatment approaches and comprehensive support services throughout the region. From minimally invasive mediastinal surgery to more complex procedures, our multidisciplinary cardiothoracic surgery team is committed to providing coordinated care and guidance at every stage of the treatment journey for patients in Brooksville, Spring Hill, Crystal River and surrounding communities.
Schedule a consultation to learn more.