Surgery: Recommendations for Surgeons

Differential diagnosis and treatment of mediastinal mass is challenging. Several strategies are available to obtain a diagnostic tissue and to resect the mass. For mass with well-marked margins and without signs of invasiveness (i.e., neurinoma, cystic lesion, mature teratoma), complete resection is indicated, being diagnostic and therapeutic. The surgical strategy (minimally invasive or open surgery) depends on the characteristics of the mass, its location, and surgeon’s experience. For mass with invasiveness of adjacent structures, a preoperative diagnosis obtained with transcutaneous biopsy, endoscopy, mediastinotomy, mediastinoscopy, or thoracoscopy according to the location of the mass is mandatory before proceeding with surgery.