The document discusses mediastinal tumors, which are masses or growths located in the mediastinum, the area within the chest between the lungs. It describes the different types of tumors that can occur in the various sections of the mediastinum and their causes. It also outlines some common symptoms, diagnostic tests, treatment options, and prognosis for different mediastinal tumors.

1. Mediastinal Tumors Ana M. Wright

2. The Mediastinum http://mywebpages.comcast.net/wnor/thoraxlesson3.htm

3. Anterior Superior 54% Thymus Gland Aortic Arch SVC Superior Vena Cava Lymph Node Parathyroid Gland Ectopic Thyroid Tissue

4. Middle 20% Pericardium Heart Great Vessels Trachea Trachea Bifurcation Main Bronchi Phrenic Nerve Hilar Lymph Node

5. Posterior 26% Esophagus Vagus nerves Sympathetic Chain Thoracic duct Thoracic desending Aorta Azygos Hemiazygosvein Paravertebral Lymphnode

6. Subdivision of mediastinum as seen on cross section anterior mediastinum (1) middle mediastinum (2) posterior mediastinum (3) http://mywebpages.comcast.net/wnor/thoraxlesson3.htm

7. Children Posterior Mediastinum Most often benign 2/3 of tumors symptomatic

8. Adult Anterior Mediastinum Often Malignant Ages 30 – 50 1/3 of tumors are symptomatic

9. Malignancy All tumors 25% Per Section Anterior Superior 59% Posterior 16% Middle 16%

10. Etiology of Tumors Lympathic tumors 45% in Children Anterior Adult Second more common anterior Found in mediastinum Immunoblastic T-cell Immunoblastic B-cell Follicular center cell Lymphoblastic Hodgkin Lymphoma (nodular sclerosing type)-

11. Malignant Tumors Invasion Structure Tracheobronchial tree and lungs Esophagus Superior Vena Cava Pleura and Chest Wall Intrathoracic nerves

12. Primary Mediastinal Tumors 10% of mediastinal masses Thymic carcinoma Neuroendocrine carcinoma Germ-cell tumors (GCT) Lymphoma Neurogenic tumors Parathyroid Tumors Mesenchymal Tumors

13. Symptoms Cough Shortness of Breath Chest pain Fever Chills Night Sweats Hemoptysis Hoarseness

14. Diagnostic Chest X-Rays CT ( Computed Tomography) MRI CT guided needle biopsy Mediastinoscopy with biopsy Radionuclide Scanning

15. Treatment Varies according location of tumors Common is Surgical resection Thymic Cancer – Surgery follow by radiation/or chemotherapy Exception Lymphatic Tumors Mesenchimal Tumors (Rhabdomyosarcoma)

16. Prognosis Varies depending on type of tumors and resection. Benign tumors – excellent prognosis Malignant tumors – depends on the type

17. Malignant Tumors Prognosis Mediastinal Lymphoma Malignant Mesenchymal Tumors Mediastinal Parathyroid Carcinoma Intrathoracic goiter with Occult Malignancy

18. Bibliography 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. 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 . 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. 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. 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

19. 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. 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 8. Mediastinal Tumors. 2004. Thirayost’s Page. [online] Retrieved 7/16/2004. http://www.geocities.com/thirayost2/web_health/mediatinal.html . 9. Medline Plus 2004. Medical Encyclopedia: Mediastinal Tumor [online] Retrieved 7/21/2004. http://www.nlm.nih.gov/medlineplus/ency/article/001086.thtm . 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. 11. University of Pensylvania Health System. 2004. [online] Retrieved 7/16/2004. http://www.pennhealth.com.lency/article/001086.htm .