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What is Mediastinal Tumors?

The Mediastinum is a space between the sternum (Breast Bone) and the spinal cord and laterally bounded by both Lungs and it mainly encompasses the heart, trachea and esophagus, aorta and thymus gland. Mediastinal masses are rare tumors and there are no such etiological factors. The usual age of presentation is 30 to 50 years but it can occur at any age and from any tissue of Mediastinum..

Who is affected by mediastinal tumors?

There are various types of Benign and Malignant tumors that can arise from the Mediastinum. Thymoma, Germ Cell Tumors, Thymic Carcinomas are common in anterior Mediastinum. Congenital cysts, Lymphoma occurs in the middle Mediastinum, Neurogenic Tumor which is more common in the posterior Mediastinum.

Diagnosis

CECT-Chest is an investigation of choice, if, suspected Carcinoma or Lymphoma then PET-CT needs to be done, X-Ray Chest can detect Mediastinal mass in the asymptomatic patients, MRI, Mediastinoscopy Tumor Markers (BHCG, AFP, LDH ), Ultrasound of Scrotum (if suspected Germ Cell Tumor in Males) and a Biopsy of Mediastinal are a prerequisite for evaluation and confirmation for diagnosis..

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Symptoms

    Anterior (front) mediastinum

  • Most of the time Mediastinal Tumor goes unnoticed but the common signs and symptoms are / Coughing with or without blood.
  • Thymoma and thymic cyst: These are the most common causes of a thymic mass. The majority of thymomas are benign and surrounded by a fibrous capsule.
    However, about 30% of these may be more aggressive and grow through the sac into other tissue.
  • Germ cell: The majority of germ cell neoplasms (60 to 70%) are benign and are found in both males and females.
  • Shortness of breath / Hoarseness of voice / Night sweats / Night sweats / Chills or fever / Wheezing
  • Unexplained weight loss
  • Anemia, Swollen or tender lymph nodes..

Treatment?

The Mediastinal Tumor can be treated with Surgery, Chemotherapy, and Radiation or a combination of these options. The treatment will depend on the type of Tumor, location and the overall health of the patient. For example, Thymic Cancers always require Surgery followed by Chemotherapy and Radiotherapy but Lymphomas usually require Chemotherapy first followed by Radiation Therapy. Posterior Mediastinal mass like a Neurogenic Tumor and middle Mediastinal congenital Cyst are best managed by Surgery only...

Surgery

Most of the Mediastinal mass require Surgery depending on their histology and location. Minimal Invasive VATS (keyhole) Surgery is a preferred approach in most of the cases and is very successful also...

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