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This retrospective single-centre study analyzed patients with pAMC from January 2012 to June 2025 to identify preoperative factors linked to malignant final pathology. Logistic regression assessed predictors of thymoma or germ cell tumours, supporting a PET-CT–first diagnostic algorithm.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/optimizing-diagnosis-and-surgery-for-pure-anterior-mediastinal-cysts-insights-from-a-single-centre-study/446972/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/optimizing-diagnosis-and-surgery-for-pure-anterior-mediastinal-cysts-insights-from-a-single-centre-study/446972.png","ImageObject",300,407,{"name":92,"@type":93},"Alexandar","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-05","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why are pure anterior mediastinal cysts (pAMC) clinically challenging to manage?","Question",{"text":112,"@type":113},"They are uncommon and typically benign, yet no standardized diagnostic or management guidelines exist. 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Optimizing Diagnosis and Surgery for Pure Anterior Mediastinal Cysts: Insights from a Single-Centre Study. Interdiscip CardioVasc Thorac Surg 2026; doi:10.1093/icvts/ivaf288.  \nOptimizing Diagnosis and Surgery for Pure Anterior Mediastinal Cysts: Insights from a Single-Centre Study  \nArnaud Rieg ; Axel Rouch ; Pierre Rabinel; Claire Renaud ; Nomie Vantaux; Mathilde Cazaux;  \nLaurent Brouchet ; Romain Verg􀀃  \nDepartment of Thoracic Surgery, Toulouse University Hospital, Toulouse 31400, France  \n􀀃 Corresponding author. Department of Thoracic Surgery, Toulouse University Hospital, 24 Chemin de Pouvourville, 31400 Toulouse, France.  \n([verge.r@chu-toulouse.fr](verge.r@chu-toulouse.fr)).  \nReceived: July 18, 2025; Revised: October 6, 2025; Accepted: November 8, 2025  \nGraphical abstract  \nAbstract  \nObjectives: Pure anterior mediastinal cysts (pAMC) are uncommon and typically benign lesions. In contrast to solid anterior mediastinal tumours, there are no standardized diagnostic or management guidelines, despite a small but clinically significant risk of malignancy. The goal of this study was to identify preoperative factors associated with malignancy in order to develop a clinical algorithm to guide the diagnosis and management of pAMC.  \nTHORACIC ONCOLOGY  \n© The Author(s) 2025. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.  \nThis is an Open Access article distributed under the terms of the Creative Commons Attribution License ([https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/)), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.  \n2 Interdisciplinary CardioVascular and Thoracic Surgery, 2026, Volume 41, Issue 1  \nMethods: This retrospective single-centre study was conducted at Toulouse University Hospital and included patients diagnosed with pAMC between January 2012 and June 2025. Logistic regression was used to identify preoperative predictors of thymoma or germ cell tumours.  \nResults: A total of 70 patients were diagnosed with pAMC, 26 of whom underwent surgical resection. On multivariate analysis, hypermetabolism on positron emission tomography–computed tomography (PET-CT) was significantly associated with a final pathological diagnosis of thymoma or germ cell tumour (odds ratio, 43.21 [2.81-663. 93], P ¼ .007). Lesion size greater than 4 cm was also associated with malignancy on univariate analysis (odds ratio: 10.50 [1.50-73.67], P ¼ .02), though this did not remain significant in multivariate analysis. Based on these findings, we proposed a decision-making algorithm incorporating PET-CT as a first-line investigation.  \nConclusions: Hypermetabolism on PET-CT is a strong preoperative predictor of malignancy in lesions presenting as pAMC. Prospective multicentre studies are warranted to validate additional prognostic markers and optimize imaging strategies for the management of pAMC.  \nKeywords: pure anterior mediastinal cysts; thymic cysts; thymoma.  \nINTRODUCTION  \nPure anterior mediastinal cysts (pAMC) are uncommon lesions that may be either congenital—arising during embryogenesis—or acquired later in life.1 They are most often identified incidentallyon images obtained for unrelated indications, because the majority remain asymptomatic.2 However, when sufficiently large, pAMC may cause compressive symptoms due to the effect of the mass on adjacent mediastinal structures.3  \nIn contrast to the well-established diagnostic and therapeutic protocols for anterior mediastinal solid tumours,4–7 there are currently no standardized guidelines for the evaluati","cbCaisB179neYqz4","https://ap.wps.com/l/cbCaisB179neYqz4","pdf",951920,"English","# Abstract\n# Objectives\n# Methods\n# Results\n# Conclusions\n# Keywords\n# Introduction\n# Material and Methods\n## Study population\n## Diagnostic and therapeutic workflow","[{\"question\":\"Why are pure anterior mediastinal cysts (pAMC) clinically challenging to manage?\",\"answer\":\"They are uncommon and typically benign, yet no standardized diagnostic or management guidelines exist. A small but notable proportion can still harbor malignancy.\"},{\"question\":\"What method and time range were used in the single-centre study?\",\"answer\":\"A retrospective single-centre design was conducted at Toulouse University Hospital. Patients diagnosed with pAMC between January 2012 and June 2025 were included.\"},{\"question\":\"Which preoperative factor showed the strongest association with malignancy?\",\"answer\":\"Hypermetabolism on PET-CT was significantly associated with a final pathological diagnosis of thymoma or germ cell tumour.\"}]","Optimizing Diagnosis and Surgery for Pure Anterior Mediastinal Cysts - Insights from a Single-Centre Study | PDF",1790718007]