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Simple Mediastinal Cysts: Resect Them All?

Ronald B. Ponn
Author and Funding Information

Affiliations: New Haven, CT
 ,  Dr. Ponn is Associate Chief of Surgery at Yale New Haven Hospital.

Correspondence to: Ronald B. Ponn, MD, FCCP, Yale New Haven Hospital, 330 Orchard St, Suite 300, New Haven, CT 06511; e-mail: rbponn@aol.com



Chest. 2003;124(1):4-6. doi:10.1378/chest.124.1.4
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I recall the first case that I “scrubbed on” as an eager medical student in 1973 at a Boston teaching hospital was that of a man of about 70 years who presented with a cough. Then, patients were hospitalized for “workup” and “buffing up” in advance of the operation. The medical student was first to interact with the patient: take the history and perform the physical examination, type or write the findings on the chart, order tests that the residents wanted, and report the results on morning rounds (very early morning rounds; 5:30 am, to be exact). In this case, the chest radiograph showed a left mid-lung field opacity. Linear tomograms may have been performed, but CT scanning was not available. Because of the possibility of cancer, the patient underwent a full posterolateral thoracotomy and was found to have a pseudotumor (ie, fluid in the interlobar fissure). The surgical team was pleased that there was no cancer and related the good news to the patient, who also was pleased, and he was discharged from the hospital about 10 days later. The surgeons acted in the best interests of the patient based on the information available. I do not know whether his cough was relieved by surgical intervention, but I suspect not.

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