Mediastinal Tumours

What are Mediastinal Tumors?

Mediastinum is the cavity that separates the lungs from the rest of the chest. It is surrounded by the breastbone in front, the spine in back, and the lungs on either sides. The mediastinum contains the heart, aorta, esophagus, thymus and trachea. Mediastinal tumors grow in this cavity. They can be either benign or cancerous.

What are the risk factors for Mediastinal Tumors?

Mediastinal tumors are rare. The location and type of mediastinal tumor vary according the age of the patient. 

In children, the tumors usually are most common in the back of the mediastinum (posterior mediastinum), non-cancerous (benign) and usually arise from the nerves (neurogenic).

In adults, the tumors are usually in the front of the mediastinum (anterior mediastinum) and are generally cancerous (malignant).

Mediastinal tumors develop in one of three areas of the mediastinum: the anterior (front), the middle, or the posterior (back).

What are the signs and symptoms of a Mediastinal Tumor?

Most of the mediastinal tumors cause no symptoms and are found on a chest X-Ray done for other reasons. Symptoms that do occur are due to pressure on surrounding structures and may include:

  • Chest pain
  • Fever
  • Coughing up blood
  • Hoarseness of voice
  • Shortness of breath
  • Swollen lymph nodes
  • Weight loss
  • Wheezing

How are Mediastinal Tumors diagnosed?

A medical history and physical examination conducted by your doctor may show:

  • Fever
  • High-pitched breathing sound
  • Swollen or tender lymph nodes
  • Weight loss
  • Wheezing

Fairly large tumour seen in the anterior mediastinum
(just behind the breast bone)

Additional tests to confirm your diagnosis may include:

  • Chest x-ray
  • CT scan of the chest
  • MRI

A tissue sample may be obtained by:

  • CT-guided needle biopsy
  • Mediastinoscopy (a biopsy performed under anesthesia by inserting a small tube through an incision under the breast bone). This procedure will help your doctor accurately diagnose the type of tumor you have.

How are Mediastinal Tumors treated?

Treatment for mediastinal tumors will depend on their location and will be determined by your doctor. Complete surgical removal is the first step in the treatment of mediastinal tumors. Once the tumor is removed, your doctor may use chemotherapy and/or radiation therapy to destroy remaining cancer cells.

Surgery For Mediastinal Tumour

Complete surgical removal is the treatment of choice for Mediastinal Tumors. Majority of these tumours can be removed by the minimally invasive i.e. VATS (link) approach. Larger or complex ones may need open surgery.

Once diagnosed, they must be removed as early as possible. Left untreated, mediastinal tumors may grow larger and can cause spinal cord compression or spread to nearby structures, such as the heart.

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