Mediastinal tumors form in the cavity that separates the lungs and contains the heart, the large blood vessels, the trachea, the thymus, and connective tissues.

Alternative Names

Mediastinal mass; Thymoma; Lymphoma; Teratoma; Thyroid tumor; Mediastinal lymphadenopathy; Neurogenic tumors

Causes, incidence, and risk factors

The mediastinum is the part of the chest between the sternum and the spinal column. It contains the esophagus, trachea, heart, and other important structures. The mediastinum is divided into three sections:

the anterior (front)

the middle

the posterior (back)

Overall, mediastinal tumors are rare. The most common location for these tumors within the mediastinum varies according to the age of the patient. In children, tumors are more common in the posterior mediastinum. These often begin in the nerves and are often benign. In contrast, most mediastinal tumors in adults occur in the anterior mediastinum and are usually malignant (cancerous) lymphomas or thymomas. These occur most commonly in people aged 30-50.

Signs and tests

Mediastinal tumors are first suspected during history and physical examination which may reveal:

Fever

Weight loss

Lymphadenopathy (swollen or tender lymph nodes)

Wheezing

Stridor

Further diagnostic evaluation typically includes:

Chest X-ray

CT scan of the chest

MRI of the chest

CT-guided needle

biopsy

Mediastinoscopy with biopsy

Treatment

Treatment for mediastinal tumors varies based on the type of tumor.

For thymic cancers, surgery is the primary treatment of choice followed by radiation and/or chemotherapy, depending on the stage of the tumor and the success of the surgery.

For lymphomas,

chemotherapy followed by radiation is the treatment of choice.

For neurogenic tumors of the posterior mediastinum, surgery is the treatment of choice.

Expectations (prognosis)

Prognosis varies based on the type of tumor. Different tumors have varying responses to chemotherapy and radiation.

Complications

Complications of mediastinal tumors include invasion of surrounding structures such as the heart, pericardium (the lining around the heart), and great vessels (the aorta and vena cava). Spinal cord compression is a complication seen in tumors of the posterior mediastinum. Radiation, surgery, and chemotherapy can all have serious complications.

Calling your health care provider

Call your health care provider if you notice symptoms of a mediastinal tumor.