Giant intrathoracic tumors

The problem of giant intrathoracic tumors is still relevant. These tumors occupy more than two parts of the mediastinum and penetrated pleural cavities. The same group includes large hemithorax tumors with spread into mediastinum and compression of adjacent anatomical structures. Many authors all over the world published different aspects of this issue (diagnostic, oncologic, surgical and anesthetic). We discuss some questions concerning the choice of surgical access and surgical techniques. In 1982-2024, there were 40 patients with giant intrathoracic tumors (20 teratomas, 12 solitary fibrous tumors, 4 thymomas, 2 sarcomas, 1 neurinoma and 1 chemodectoma). Transthoracic needle core biopsy was performed in 21 patients. Eight patients had previous attempts of tumor resection. Surgical accesses for giant intrathoracic tumor resection were sternotomy in 25 cases, lateral thoracotomy in 7 cases, hemiclamshell in 2 cases and combined access in 6 cases. Postoperative morbidity was 17.5% (7 patients had different complications after surgery). Of these, 3 ones died (mortality rate 7.5%). Thirty-three (82.5%) patients recovered after surgery well.