A 36-year-old female developed dyspnea on exertion that has progressed over 3 months. Chest film reveals a left anterior mediastinal mass with evidence of elevated left hemidiaphragm. CT indicates probable invasion of the pericardium. Paratracheal or subcarinal adenopathy is not identified. Appropriate intervention in this patient would include:
A. A median sternotomy with radical resection of the tumor, sacrificing the left phrenic nerve and excising the involved pericardium.
B. A mediastinoscopy with biopsy.
C. A left anterolateral thoracotomy or median sternotomy with generous biopsy of the tumor.
D. Observation with repeat chest radiography in 3 months.
Answer:C
A 36-year-old female developed dyspnea on exertion that has progressed over 3 months. Chest film reveals a left anterior mediastinal mass with evidence of elevated left hemidiaphragm. CT indicates probable invasion of the pericardium. Paratracheal or subcarinal adenopathy is not identified. Appropriate intervention in this patient would include:
A. A median sternotomy with radical resection of the tumor, sacrificing the left phrenic nerve and excising the involved pericardium. B. A mediastinoscopy with biopsy. C. A left anterolateral thoracotomy or median sternotomy with generous biopsy of the tumor. D. Observation with repeat chest radiography in 3 months.