Mediastinal Tumors Ana M. Wright
The Mediastinum http://mywebpages.comcast.net/wnor/thoraxlesson3.htm
Anterior Superior 54% <ul><li>Thymus Gland </li></ul><ul><li>Aortic Arch </li></ul><ul><li>SVC Superior Vena Cava </li></u...
Middle 20% <ul><li>Pericardium </li></ul><ul><li>Heart </li></ul><ul><li>Great Vessels </li></ul><ul><li>Trachea </li></ul...
Posterior 26% <ul><li>Esophagus </li></ul><ul><li>Vagus nerves </li></ul><ul><li>Sympathetic Chain </li></ul><ul><li>Thora...
Subdivision of mediastinum  as seen on cross section   <ul><li>anterior  mediastinum (1)  </li></ul><ul><li>middle  medias...
Children <ul><li>Posterior Mediastinum </li></ul><ul><li>Most often benign </li></ul><ul><li>2/3 of tumors symptomatic </l...
Adult <ul><li>Anterior Mediastinum </li></ul><ul><li>Often Malignant </li></ul><ul><li>Ages 30 – 50 </li></ul><ul><li>1/3 ...
Malignancy <ul><li>All tumors 25% </li></ul><ul><ul><li>Per Section </li></ul></ul><ul><ul><ul><li>Anterior Superior 59% <...
Etiology of Tumors <ul><li>Lympathic tumors </li></ul><ul><ul><li>45% in Children Anterior </li></ul></ul><ul><ul><li>Adul...
Malignant Tumors Invasion Structure <ul><li>Tracheobronchial tree and lungs </li></ul><ul><li>Esophagus </li></ul><ul><li>...
Primary Mediastinal Tumors <ul><li>10% of mediastinal masses </li></ul><ul><ul><li>Thymic carcinoma </li></ul></ul><ul><ul...
Symptoms <ul><li>Cough </li></ul><ul><li>Shortness of Breath </li></ul><ul><li>Chest pain </li></ul><ul><li>Fever </li></u...
Diagnostic <ul><li>Chest X-Rays </li></ul><ul><li>CT ( Computed Tomography) </li></ul><ul><li>MRI </li></ul><ul><li>CT gui...
Treatment <ul><li>Varies according location of tumors </li></ul><ul><li>Common is Surgical resection </li></ul><ul><ul><li...
Prognosis <ul><li>Varies depending on type of tumors and  </li></ul><ul><li>resection. </li></ul><ul><li>Benign tumors – e...
Malignant Tumors Prognosis <ul><li>Mediastinal Lymphoma </li></ul><ul><li>Malignant Mesenchymal Tumors </li></ul><ul><li>M...
<ul><li>Bibliography </li></ul><ul><li>1. Bacha, E. A. M.D., A.R. Chapelier,  M.D. PhD., P. Macchiarini, M.D., E. Fadel, M...
<ul><li>6. Kuchiki, H., J. Yasuda, T. Kayama, Y. Murakami, and T. Sekiya. 1999. Detection of DNA Abnormalities by Arbitrar...
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Mediastinal tumors

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Mediastinal tumors

  1. 1. Mediastinal Tumors Ana M. Wright
  2. 2. The Mediastinum http://mywebpages.comcast.net/wnor/thoraxlesson3.htm
  3. 3. Anterior Superior 54% <ul><li>Thymus Gland </li></ul><ul><li>Aortic Arch </li></ul><ul><li>SVC Superior Vena Cava </li></ul><ul><li>Lymph Node </li></ul><ul><li>Parathyroid Gland </li></ul><ul><li>Ectopic Thyroid Tissue </li></ul>
  4. 4. Middle 20% <ul><li>Pericardium </li></ul><ul><li>Heart </li></ul><ul><li>Great Vessels </li></ul><ul><li>Trachea </li></ul><ul><li>Trachea Bifurcation </li></ul><ul><li>Main Bronchi </li></ul><ul><li>Phrenic Nerve </li></ul><ul><li>Hilar Lymph Node </li></ul>
  5. 5. Posterior 26% <ul><li>Esophagus </li></ul><ul><li>Vagus nerves </li></ul><ul><li>Sympathetic Chain </li></ul><ul><li>Thoracic duct </li></ul><ul><li>Thoracic desending </li></ul><ul><li>Aorta </li></ul><ul><li>Azygos </li></ul><ul><li>Hemiazygosvein </li></ul><ul><li>Paravertebral Lymphnode </li></ul>
  6. 6. Subdivision of mediastinum as seen on cross section <ul><li>anterior mediastinum (1) </li></ul><ul><li>middle mediastinum (2) </li></ul><ul><li>posterior mediastinum (3) </li></ul>http://mywebpages.comcast.net/wnor/thoraxlesson3.htm
  7. 7. Children <ul><li>Posterior Mediastinum </li></ul><ul><li>Most often benign </li></ul><ul><li>2/3 of tumors symptomatic </li></ul>
  8. 8. Adult <ul><li>Anterior Mediastinum </li></ul><ul><li>Often Malignant </li></ul><ul><li>Ages 30 – 50 </li></ul><ul><li>1/3 of tumors are symptomatic </li></ul>
  9. 9. Malignancy <ul><li>All tumors 25% </li></ul><ul><ul><li>Per Section </li></ul></ul><ul><ul><ul><li>Anterior Superior 59% </li></ul></ul></ul><ul><ul><ul><li>Posterior 16% </li></ul></ul></ul><ul><ul><ul><li>Middle 16% </li></ul></ul></ul>
  10. 10. Etiology of Tumors <ul><li>Lympathic tumors </li></ul><ul><ul><li>45% in Children Anterior </li></ul></ul><ul><ul><li>Adult Second more common anterior </li></ul></ul><ul><ul><ul><li>Found in mediastinum </li></ul></ul></ul><ul><ul><ul><ul><li>Immunoblastic T-cell </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Immunoblastic B-cell </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Follicular center cell </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Lymphoblastic </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Hodgkin Lymphoma (nodular sclerosing type)- </li></ul></ul></ul></ul>
  11. 11. Malignant Tumors Invasion Structure <ul><li>Tracheobronchial tree and lungs </li></ul><ul><li>Esophagus </li></ul><ul><li>Superior Vena Cava </li></ul><ul><li>Pleura and Chest Wall </li></ul><ul><li>Intrathoracic nerves </li></ul>
  12. 12. Primary Mediastinal Tumors <ul><li>10% of mediastinal masses </li></ul><ul><ul><li>Thymic carcinoma </li></ul></ul><ul><ul><li>Neuroendocrine carcinoma </li></ul></ul><ul><ul><li>Germ-cell tumors (GCT) </li></ul></ul><ul><ul><li>Lymphoma </li></ul></ul><ul><ul><li>Neurogenic tumors </li></ul></ul><ul><ul><li>Parathyroid Tumors </li></ul></ul><ul><ul><li>Mesenchymal Tumors </li></ul></ul>
  13. 13. Symptoms <ul><li>Cough </li></ul><ul><li>Shortness of Breath </li></ul><ul><li>Chest pain </li></ul><ul><li>Fever </li></ul><ul><li>Chills </li></ul><ul><li>Night Sweats </li></ul><ul><li>Hemoptysis </li></ul><ul><li>Hoarseness </li></ul>
  14. 14. Diagnostic <ul><li>Chest X-Rays </li></ul><ul><li>CT ( Computed Tomography) </li></ul><ul><li>MRI </li></ul><ul><li>CT guided needle biopsy </li></ul><ul><li>Mediastinoscopy with biopsy </li></ul><ul><li>Radionuclide Scanning </li></ul>
  15. 15. Treatment <ul><li>Varies according location of tumors </li></ul><ul><li>Common is Surgical resection </li></ul><ul><ul><li>Thymic Cancer – Surgery follow by radiation/or chemotherapy </li></ul></ul><ul><li>Exception </li></ul><ul><ul><li>Lymphatic Tumors </li></ul></ul><ul><ul><li>Mesenchimal Tumors (Rhabdomyosarcoma) </li></ul></ul>
  16. 16. Prognosis <ul><li>Varies depending on type of tumors and </li></ul><ul><li>resection. </li></ul><ul><li>Benign tumors – excellent prognosis </li></ul><ul><li>Malignant tumors – depends on the type </li></ul>
  17. 17. Malignant Tumors Prognosis <ul><li>Mediastinal Lymphoma </li></ul><ul><li>Malignant Mesenchymal Tumors </li></ul><ul><li>Mediastinal Parathyroid Carcinoma </li></ul><ul><li>Intrathoracic goiter with Occult Malignancy </li></ul>
  18. 18. <ul><li>Bibliography </li></ul><ul><li>1. Bacha, E. A. M.D., A.R. Chapelier, M.D. PhD., P. Macchiarini, M.D., E. Fadel, M.D., and P.G. Dartevelle, M.D. 1998. Surgery for Invasive Primary Mediastinal Tumors. The Society of Thoracic Surgeons. Elsevier Science Inc. 1998; 66: 234-239. </li></ul><ul><li>2. Eggerstedt, J. M., M.D. 2003 Lymphomas, Endocrine, Mesenchymal, and Other Rare Tumors of the Mediastinum. [online] Retrieved 7/19/2004. http://www.emedicine.com/med/topic3455.htm . </li></ul><ul><li>3. Graccone, G., R. Musella, O. Betetto, M. Donadio, and A. Calciati. 1985. Cisplatin-Cntaining Chemotherapy in the Treatment of Invasive Thymoma. U.S. Department of Health and Human Services; Cancer Treatment Report, June 1985; 69:695-697. </li></ul><ul><li>4. Hartmann, J.T., C.R. Nichols, J.P. Droz, A. Horwich, A. Gerl, S.D. Fossa, J. Beyer, J. Pont, K Fizazi, L. Einhorn, L. Kanz, C. Bokemeyer. 2000. Hematologic Disorders Associated With Primary Mediastinal Nonseminomatus Germ Cell Tumors. 2000. U.S. Department of Health and Human Services; Journal of the National Cancer Institute; 92:54-61. </li></ul><ul><li>5. Kawakami, M., K. Ito, K. Yoshimura, and H. Tanaka. 2003. A Case of Mediastinal Goiter. Auris Nasus Larynx 31(2004) 183-187 www.elservier.com/locate/anl </li></ul>
  19. 19. <ul><li>6. Kuchiki, H., J. Yasuda, T. Kayama, Y. Murakami, and T. Sekiya. 1999. Detection of DNA Abnormalities by Arbitrarily Primed PCR Fingerprinting: Amplification of MDM2 Gene in a Mediastinum Fibrosarcoma. Biochemical and Biophisical Research Communication. 1999. 258: 271-277. </li></ul><ul><li>7. Macchiarini, P. and Ostertag, H. 2004. Uncommon Primary Mediastinal Tumours. The Lancet Oncology Vol. 5 February 2004: 107-118. [online]. http://oncology.thelancet.com </li></ul><ul><li>8. Mediastinal Tumors. 2004. Thirayost’s Page. [online] Retrieved 7/16/2004. http://www.geocities.com/thirayost2/web_health/mediatinal.html . </li></ul><ul><li>9. Medline Plus 2004. Medical Encyclopedia: Mediastinal Tumor [online] Retrieved 7/21/2004. http://www.nlm.nih.gov/medlineplus/ency/article/001086.thtm . </li></ul><ul><li>10.Meral, M., M. Akgun, H. Kaynar, A. Mirici, M. Gorguner, L. Saglam, and F. Erdogan. 2003. Mediastinal Lymphadenopathy due to Mycobacterial Infection. Short Communication. Jpn. J. Infect. Dis. 2004. 57:124-126. </li></ul><ul><li>11. University of Pensylvania Health System. 2004. [online] Retrieved 7/16/2004. http://www.pennhealth.com.lency/article/001086.htm . </li></ul>
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