Problems in the management of mediastinal tumours.

Five cases of anterior mediastinal tumour are presented. Two cases were asymptomatic, being discovered by routine chest radiography. The remainder presented with dyspnoea, dysphagia and a sinus over the manubrium. Each case provided a lesson in the management of the mediastinal mass. Pathologies included haemangioma, teratoma, secondary carcinoma from the kidney and a malignant thymoma which caused cardiac tamponade. Features of interest in the presentation, treatment and pathology are discussed. It is concluded that a full investigation of mediastinal swellings is needed before mediastinoscopy is performed; that incision of swellings in the base of the neck should be avoided; and it is suggested that the management of asymptomatic mediastinal haemangioma in adults may be expectant.