Treatment of Mediastinal Tumor

About the disease

Mediastinal tumor, also known as mediastinal neoplasm, is an abnormal growth of the tissue, which develops in mediastinum, located in the middle of the chest. It includes such organs, as sternum, heart, and trachea. Mediastinal tumor can develop either at the back or front of the mediastinum. Depending on the location of tumor, it can be either malignant or benign. In children with mediastinal tumor this condition is usually benign and it develops at the back of mediastinum. Tumors, which develop at the front of mediastinum, are in most cases cancerous and common in adults over 30 years old. Nonetheless, 70% of all cases of mediastinal tumors are benign and do not become malignant over the course of disease progression. Rarely, mediastinal tumor develops as a result of metastasis from cancer of other organs. People with lung cancer and cancer of esophagus are at the biggest risk of developing mediastinal tumor in progressed stages of their primary cancers. Most cases of benign mediastinal tumor are caused by lymphomas, cysts, and thyroid masses, which can become tumors, if not identified early.       

Symptoms

• Long term cough
• Heavy breathing
• Pain in the chest
• Fatigue
• Fever
• Changes in the voice
• Weight loss
• Swollen lymph nodes in the mediastinum area
• Respiratory problems

Diagnosis

• Chest X-Ray is the most commonly used method for diagnosis of mediastinal tumor, as it can show its location, size, and extent of progression.
• MRI and CT scan are used for more precise image of the chest if X-Ray was not sufficient enough to provide full information about the tumor.
• Biopsy of the mediastinum is used if there is suspicion of malignancy, which needs to be checked. The sample of tumor is extracted and later examined under the microscope.

Treatment

• Chemotherapy uses special cytotoxic drugs, which can shrink and scatter the cells, that form tumor. It is usually applied before or after the surgery and in some cases is the only treatment if the size of tumor is small.
• Radiation therapy also aims to shrink the tumor by using high-energy rays.
• Resection of the tumor is surgery, during which surgeon removes the tumor through excision into the chest cavity. A surgeon can also use a less invasive resection, which is video- assisted and is known as thoracic surgery. It has the same principle as endoscopic surgery. 

Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko