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'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''


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{{Mediastinal tumor}}
 
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== [[Mediastinal tumor overview|Overview]] ==


==Overview==
== [[Mediastinal tumor historical perspective|Historical Perspective]] ==


Masses in the anterior portion of the [[mediastinum]] can include [[thymoma]], [[lymphoma]], and [[germ cell tumor]]s including [[teratoma]].  [[Lung cancer]] typically spreads to the [[lymph node]]s in the [[mediastinum]].
== [[Mediastinal tumor classification|Classification]] ==


Anterior [[mediastinum|mediastinal]] compartment, also known as anterosuperior compartment, is anterior to the [[pericardium]]. Masses in this area is more likely to be malignant than those in other compartments Most common masses found here include [[thymoma]]s, [[germ cell tumor]]s, [[lymphoma]]s, [[thyroid]] tissue, and [[parathyroid]] lesions.
== [[Mediastinal tumor pathophysiology|Pathophysiology]] ==


==Thymoma==
== [[Mediastinal tumor causes|Causes]] ==
{{main|thymoma}}
Most common primary anterior mediastinal tumor (20%) in adults but rarely seen in children. It can be classified as lymphocytic, epithelial, or spindle cell histologies, but this is not very significant clinically. Tonofibrils seen under [[electron microscopy]] can differentiate [[thymoma]] from other tumors such as [[carcinoid]], Hodgkin's, and [[seminoma]]. Patients are usually asymptomatic but can present with [[myasthenia gravis]]-related symptoms, [[substernal pain]], [[dyspnea]], or [[cough]]. Invasive tumors can produce compression effects such as [[superior vena cava syndrome]].


[[Thymoma]]s are diagnosed with [[CT]] or [[MRI]] revealing mass in anterior [[mediastinum]].
== [[Mediastinal tumor differential diagnosis|Differentiating Mediastinal Tumor from other Diseases]] ==


Therapy in stage I tumors consists of surgical resection with good prognosis.
== [[Mediastinal tumor epidemiology and demographics|Epidemiology and Demographics]] ==


Stage II-III requires maximal resection possible followed by radiation.
== [[Mediastinal tumor risk factors|Risk Factors]] ==


Stage IV disease requires addition of cisplatin-based chemotherapy in addition to those in stage II and III.
== [[Mediastinal tumor screening|Screening]] ==


For those with invasive thymoma, treatment is based on induction chemotherapy, surgical resection, and post-surgical radiation.
== [[Mediastinal tumor natural history|Natural History, Complications and Prognosis]] ==


5-year survival for invasive thymoma is between 12-54% regardless of any [[myasthenia gravis]] symptoms.
== Diagnosis ==


==Lymphoma==
[[Mediastinal tumor staging|Staging]] | [[Mediastinal tumor history and symptoms|History and Symptoms]] | [[Mediastinal tumor physical examination|Physical Examination]] | [[Mediastinal tumor laboratory tests|Laboratory Findings]] | [[Mediastinal tumor electrocardiogram|Electrocardiogram]] | [[Mediastinal tumor chest x ray|Chest X Ray]] | [[Mediastinal tumor CT|CT]] | [[Mediastinal tumor MRI|MRI]] | [[Mediastinal tumor echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Mediastinal tumor other imaging findings|Other Imaging Findings]] | [[Mediastinal tumor other diagnostic studies|Other Diagnostic Studies]]
{{main|lymphoma}}
Secondary most common primary anterior mediastinal mass in adults. Most are seen in the anterior compartment and rest are seen in middle compartment. Hodgkin's usually present in 40-50's with nodular sclerosing type, and non-Hogdkin's in all age groups. Can also be primary mediastinal B cell lymphoma with exceptionally good prognosis <ref>J Exp Med. 2003 Sep 15;198(6):851-62</ref> <ref>Leukemia and Lymphoma, Volume 49, Issue 6 June 2008 , pages 1050 - 1061.</ref> <ref>The Oncologist, Vol. 11, No. 5, 488-495, May 2006; doi:10.1634/theoncologist.11-5-488</ref>


Common symptoms include [[fever]], [[weight loss]], [[night sweat]]s, and compressive symptoms such as [[pain]], [[dyspnea]], [[wheezing]], [[SVC syndrome]], [[pleural effusion]]s.
== Treatment ==


Diagnosis usually by [[CT]] showing lobulated mass. Confirmation done by tissue [[biopsy]] of accompanying nodes if any, [[mediastinoscopy]], mediastinotomy, or [[thoracotomy]]. FNA biopsy usually not adequate.
[[Mediastinal tumor medical therapy|Medical Therapy]] | [[Mediastinal tumor surgery|Surgery]] | [[Mediastinal tumor primary prevention|Primary Prevention]] | [[Mediastinal tumor secondary prevention|Secondary Prevention]] | [[Mediastinal tumor cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Mediastinal tumor future or investigational therapies|Future or Investigational Therapies]]


Treatment of mediastinal Hodgkin's involves chemotherapy and/or radiation. 5 year survival is now around 75%. Large-cell type may have somewhat better prognosis. Surgery is generally not performed because of invasive nature of tumor.
== Case Studies ==


Of all [[lymphoproliferative disorders|cancers involving the same class of blood cell]], 2% of cases are mediastinal large B cell lymphomas.<ref name="isbn0-7817-5007-5">{{cite book
[[Mediastinal tumor case study one|Case #1]]
|author=Turgeon, Mary Louise
|title=Clinical hematology: theory and procedures
|publisher=Lippincott Williams & Wilkins
|location=Hagerstown, MD
|year=2005
|pages=283
|isbn=0-7817-5007-5
|quote=Frequency of lymphoid neoplasms. (Source:  Modified from WHO Blue Book on Tumour of Hematopoietic and Lymphoid Tissues. 2001, p. 2001.)
}}</ref>


==References==
{{Tumors}}
{{Reflist|2}}


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[[Category:Types of cancer]]
[[Category:Types of cancer]]
[[Category:Mature chapter]]
[[Category:Mature chapter]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]

Latest revision as of 02:32, 27 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Historical Perspective

Classification

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Causes

Differentiating Mediastinal Tumor from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Chest X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

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