Page 215 - Livre électronique des RFTP 2024

PROFILE OF OPERATED MEDIASTINAL TUMORS IN

CHILDREN : MONOCENTRIC EXPERIENCE

ZIED CHAARI, EMNA CHAABOUNI KRICHEN, RAHMA JARRAYA, AYMEN BEN AYED,
ABDESSALEM HENTATI, IMED FRIKHA

HABIB BOURGUIBA UNIVERSITY HOSPITAL, DEPARTMENT OF THORACIC AND
CARDIOVASCULAR SURGERY

OBJECTIVES: The mediastinum is the most common site for the development of
mediastinal tumors (MT) in the pediatric population. They often pose a diagnostic
and therapeutic challenge. The aim of this study was to report the experience of
our center and the profile of operated MT in children.

METHODS : Through a retrospective study, we collected all cases of operated MT
in children aged between 1 and 16 years in the department of thoracic surgery in
Habib Bourguiba University Hospital between 1990 and 2022. We did not include
children who had surgical biopsies for MT (including lymph nodes), or with
confirmed not operated tumors.

RESULTS: Our series included 18 children operated-on for confirmed MT, with a
median age of 13.5 years (2 – 16 years), and a clear boys majority (Sex Ratio = 3.5).
The onset of clinical signs was indicative of MT in 83% of cases dominated by chest
pain (55%), dyspnea (44%), and fever (22%). Fortuitous discovery was noticed for 3
children (17%). All operated children had complete tumor resection, mainly by open
surgery (89%). A minimally-invasive approach was used for 2 children (11%).
Thoracotomy and sternotomy were the most used approaches in 39% and 22%
respectively. Anterior mediastinal location was predominant (50%), followed by the
posterior one (27%). The most noted tumors were respectively thymic tumors (33%),
neurogenic tumors (22%), bronchogenic cysts and parathyroid adenomas (11%
each). Postoperative course was simple for 89% of children with a median follow-
up period of 12 months (3 – 50 months). One death was noted for a boy, 7 months
after surgery for Burkitt's lymphoma of the posterior mediastinum.

CONCLUSIONS: MT are not uncommon in children. A good preoperative diagnosis
improves the postoperative course. Minimally-invasive approach has gained more
ground and provides results similar to open surgery.

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