Mediastinal tumors are related to various diseases. To appropriately treat these diseases, thoracic surgeons must cooperate with physicians in other departments. Accurate diagnosis with computed tomography, magnetic resonance imaging, and positron-emission tomography are indispensable for these diseases. A thorough assessment of the tumor should include its size, shape, surface, relationship with adjacent organs, and other characteristics, including nodal involvement, remote metastasis, pleural dissemination, pericardial dissemination, pulmonary metastasis, invasion to chest wall, development to the vertebral canal, and hematological studies. Less-invasive procedures by means of video-assisted thoracic surgery is an option for resection of noninvasive tumors, such as Masaoka stage I and II thymomas. Whether video-assisted thoracic surgery is an appropriate surgical procedure for mediastinal tumors depends on accurate imaging diagnosis. In this article, a new method for anatomic compartment classification of the mediastinum for axial computed tomograms and x-ray films is reviewed. Additionally, the characteristics of mediastinal tumors and recent surgical treatments are described.
