Treatment of malignant mediastinal mass abroad

Mediastinum represents an anatomical area that separates vital organs and structures. The tumour frequency is 3-7% in different countries. 30% of all the mediastinal masses are malignant.


The incidence is equal for both men and women and its peak is exactly during the most socially active period from 20 to 40 years old. 


Malignant mediastinal mass causes


Causes of mediastinal masses

Malignant mediastinal mass can be of various origins; starting from the thymus gland cells, connective (fibrosarcoma), fat (liposarcoma), muscle (leiomyosarcoma), lymphoid (lymphosarcoma) tissue, and including the vessels (angiosarcoma).


An exact cause of the tumour remains unknown at the moment.


There are several factors that lead to the changes in the genetic material of the cells and significantly increase the possibility of their malignancy:

  • Genetic predisposition
  • Genetic syndromes
  • The effect of ionising radiation on the human body (X-rays, radiation)
  • Impact of certain chemical compounds called carcinogens (aniline dyes, aromatic hydrocarbons) on the person’s organism
  • Certain types of viruses that can lead to a change in the genetic material of cells (Epstein-Barr virus)


Malignant mediastinal mass symptoms


Symptoms of mediastinal mass

The development of mediastinum malformation can be latent for a long time and does not cause any feelings of discomfort for a person. In these cases, the tumour can be detected by chance during diagnostic tests for other diseases.


As the oncologic process progresses and the tumour increases in size, the following symptoms may appear:


Pain develops due to the growth of the tumour in the tissues and neural stem cells of the mediastinum. At the same time, pain sensations can have different intensity. They are located mainly behind the breastbone and can often resemble cardiac angina (compressive pain as a result of insufficient blood supply to the heart muscle).


Compression syndrome occurs when a large tumour compresses the venous stems affecting the blood outflow from the upper or lower half of the trunk, large nerves, which is manifested by the lowering of the eyelids (ptosis), in a hoarse voice (dysphonia). Compression of the large bronchi can be manifested by the broken breathing, cough.


The following phenomena are also possible:

  • Cardiac arrhythmias
  • Diminished ability to swallow (when the tumour grows into the oesophagus or squeezes it)
  • Shortness of breath, blue skin tone (with a squeezing of the heart, upper vena cava)
  • Systemic endocrine pathologies (if thyroid gland was damaged)


General cancerous intoxication appears on the latter stages of the oncologic process, characterised by severe weakness, decreased appetite or lack of it, increased body temperature, aching joints and muscles.


Malignant mediastinal mass diagnostics


Diagnostics of mediastinal mass

A doctor will explain the additional diagnostic measures right after the clinical examination (a survey, examination of the patient, palpation of tissues, in particular regional lymph nodes). Additional procedures are necessary to detect the tumour, its exact location, histological origin, size. 


Specialists will also perform a test aimed at the detection of metastases with the help of modern diagnostic techniques which include:

  • Ultrasound used to visualise the venous, arterial mediastinal vessels, nerve stems and other structures
  • Radiography of the mediastinum, as well as of the chest organs
  • CT and MRI have high resolution and can detect even the smallest tumours or metastases
  • Fine needle biopsy means taking a small area of ​​the tumour with a special thin needle in order to examine the tissue structure
  • Excision biopsy is held when the surgeon takes a piece of tissue during mediastinoscopy (an invasive procedure that involves penetration into the chest)


To determine the functional status of other organs, clinical, biochemical blood analysis, general urine analysis, laboratory examination of the functional activity of the immune system, electrocardiography, electroencephalography, external respiration function evaluation are additionally assigned by the doctor. 


The volume of the diagnostic measures is determined individually for each patient in the European hospitals as tumour location, origin, size significantly differ. 


Malignant mediastinal mass treatment abroad


Treatment of mediastinal mass abroad

The main treatment of a malignant mediastinal mass  is the surgical removal of the malformation through an open access technique or laparoscopic surgery.


If a tumour is small, metastases are absent, radical treatment is performed with complete excision of the malformation and nearby healthy tissues. Unfortunately, many tumours are unresectable, when located close to vital organs, primarily to the heart.


Palliative surgical treatment is performed at the last stages of the disease. It is aimed at the partial removal of the tumour to ease the patient’s condition triggered by the compression of the vessels, nerve stems, and bronchi. 


Radical and palliative surgical treatment of the malignant mediastinal mass is often accompanied by  radiation therapy or cytostatics (chemotherapy). 


Malignant mediastinal mass prognosis


Prognosis for malignant mediastinal mass

The entire situation depends on the histological type of malignant tumour and its location. It is impossible to give certain numbers of the patients survival as malignant mediastinal mass is not a separate disease but a whole group of pathologies. 


Nevertheless, judging on the close location of the organs their importance for the body, considerable blood supply, and prognosis is unfavourable. In the absence of proper treatment; the process quickly spreads to distant metastases. 



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