Mediastinal tumor
Thymoma - mediastinal; Lymphoma - mediastinalMediastinal tumors are growths that form in the mediastinum. This is an area in the middle of the chest that separates the lungs.
Causes
The mediastinum is the part of the chest that lies between the sternum and the spinal column, and between the lungs. This area contains the heart, large blood vessels, windpipe (trachea), thymus gland, esophagus, and connective tissues. The mediastinum is divided into three sections:
- Anterior (front)
- Middle
- Posterior (back)
Mediastinal tumors are rare.
The most common location for tumors in the mediastinum depends on the age of the person. In children, tumors are more common in the posterior mediastinum. These tumors often begin in the nerves and are noncancerous (benign).
Most mediastinal tumors in adults occur in the anterior mediastinum. They are usually cancerous (malignant) lymphomas, germ cell tumors, or thymomas (cancers of the thymus). These tumors are most common in middle aged and older adults.
Symptoms
Almost one half of mediastinal tumors cause no symptoms and are found on a chest x-ray done for another reason. Symptoms that do occur are due to pressure on (compression of) local structures and may include:
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
Read Article Now Book Mark Article- Chest pain
- Fever and chills
- Cough
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Coughing up blood (hemoptysis)
Coughing up blood
Coughing up blood is the spitting up of blood or bloody mucus from the lungs and throat (respiratory tract). Hemoptysis is the medical term for cough...
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Hoarseness
Hoarseness
Hoarseness refers to difficulty making sounds when trying to speak. Vocal sounds may be weak, breathy, scratchy, or husky, and the pitch or quality ...
Read Article Now Book Mark Article - Night sweats
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Shortness of breath
Shortness of breath
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
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Exams and Tests
A medical history and physical exam may show:
- Fever
- High-pitched breathing sound (stridor)
Stridor
Stridor is an abnormal, high-pitched, musical breathing sound. It is caused by a blockage in the throat or voice box (larynx). It is most often hea...
Read Article Now Book Mark Article - Swollen or tender lymph nodes (lymphadenopathy)
Lymphadenopathy
Lymph nodes are present throughout your body. They are an important part of your immune system. Lymph nodes help your body recognize and fight germ...
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Unintentional weight loss
Unintentional weight loss
Unexplained weight loss is a decrease in body weight, when you did not try to lose the weight on your own. Many people gain and lose weight. Uninten...
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Wheezing
Wheezing
Wheezing is a high-pitched whistling sound during breathing. It occurs when air moves through narrowed breathing tubes in the lungs.
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Further tests that may be done include:
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Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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CT-guided needle biopsy
CT-guided needle biopsy
A lung needle biopsy is a method to remove a piece of lung tissue for examination. If it is done through the wall of your chest, it is called a tran...
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CT scan of the chest
CT scan of the chest
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
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Mediastinoscopy with biopsy
Mediastinoscopy with biopsy
Mediastinoscopy with biopsy is a procedure in which a lighted instrument (mediastinoscope) is inserted in the space in the chest between the lungs (m...
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MRI of the chest
MRI of the chest
A chest MRI (magnetic resonance imaging) scan is an imaging test that uses powerful magnetic fields and radio waves to create pictures of the chest (...
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Treatment
Treatment for mediastinal tumors depends on the type of tumor and symptoms:
- Thymomas are treated with surgery. It may be followed by radiation or chemotherapy, depending on the stage of the tumor and the success of the surgery.
Radiation
Radiation therapy uses high-powered radiation (such as x-rays or gamma rays), particles, or radioactive seeds to kill cancer cells.
Read Article Now Book Mark ArticleChemotherapy
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancerShrink the cancerPrevent the cancer from ...
Read Article Now Book Mark Article - Germ cell tumors are usually treated with chemotherapy.
- For lymphomas, chemotherapy is the treatment of choice, and is possibly followed by radiation.
- For nerve-related tumors of the posterior mediastinum, surgery is the main treatment.
Outlook (Prognosis)
The outcome depends on the type of tumor. Different tumors respond differently to chemotherapy and radiation.
Possible Complications
Complications of mediastinal tumors include:
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Spinal cord compression
Spinal cord compression
Spinal cord trauma is damage to the spinal cord. It may result from direct injury to the cord itself or indirectly from disease of the nearby bones,...
Read Article Now Book Mark Article - Spread to nearby structures such as the heart, lining around the heart (pericardium), and great vessels (aorta and vena cava)
Radiation, surgery, and chemotherapy can all have serious complications.
When to Contact a Medical Professional
Contact your health care provider if you notice symptoms of a mediastinal tumor.
References
McCool FD. Diseases of the diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 86.
Triplette M, Varghese TK, Cheng GS. Mediastinal tumors and cysts. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 115.
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Lungs - illustration
The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.
Lungs
illustration
Review Date: 6/17/2024
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.