Mediastinal tumors are masses, whether benign or malignant, that develop in the space between the lungs, which contains organs such as the heart, part of the esophagus, part of the trachea, part of the aorta and thymus.
Previous: Front of the chest
Middle: Contains the pericardial sac and its contents
Posterior: Thoracic spine
In children, most tumors found in this region are benign. In adults, some are due to metastases that is a new tumor formation that arises from a previous one. In most cases, cancerous masses are related to the regions in which they are found. Thus, the most frequently found mediastinal tumors by region are:
- Anterior Mediastinal Tumors: Thymoma, Thymic Carcinoma, Germ Cell Tumors, Goiter, Parathyroid Adenoma, and Lymphoma, which can be Hodkin Lymphoma and Non-Hodkin Lymphoma types.
- Middle mediastinal tumors: bronchogenic cyst and pericardial cyst.
- Posterior mediastinal tumors: Esophageal cyst, Peripheral nerve tumors and Sympathetic ganglia tumors.
Most of these types of cancer have no unique symptoms and are often confused with other diseases. The diagnosis is made through tests such as X-rays, CT scans and MRIs, and the main symptoms of tumors in the mediastinum are:
- Dyspnea or lack of breath
- Chest pain
- Recurrent respiratory infections
Pericardial cysts are usually benign formations, which are characterized by the presence of internal fluid and whose origin is congenital, they were formed during the embryonic growth phase.
The pericardium is a saccular membrane that surrounds the heart and the roots of the great vessels. Its main function is the protection and support of the heart in the diaphragm. It has the ability to expand during contractions and has an inner layer that contains enough fluid to lubricate the heart muscles.
These cysts are usually asymptomatic and are found accidentally on routine tests such as X-rays. Although they are benign formations, their exaggerated growth compresses other organs and can lead the patient to develop heart failure.
The main symptoms of pericardial cysts are:
- Pain in one shoulder that radiates to the other
- Lack of breathe
- Heaviness in the chest
Pneumothorax is a medical condition that develops when air from the lungs accumulates between the lungs and the chest wall, causing difficulty in breathing. In more severe cases there is a displacement of the heart and other important blood vessels, which can lead to death. There are four types of Pneumothorax:
- Spontaneous pneumothorax: There is no determining cause for this to occur and it is more common in people in their 30 and 40 years. These are basically air bubbles that develop in the lungs and can burst, causing air to leak into the pleura, which is the membrane that surrounds the lungs.
- Traumatic pneumothorax: Air accumulates between the lungs and rib cage after a blow, fall, or other accident.
- Latrogenic pneumothorax: It occurs after performing a medical procedure, such as the insertion of a central venous catheter to pass medication.
- Hypertensive pneumothorax: A bursting air bubble can damage the pleura, causing air to accumulate between the lungs and chest wall. Each time a person takes a breath, a little more air accumulates in this region and is not eliminated. This accumulation of air can lead to death as the lungs become compressed and eventually dislodgement of the heart or other vessels occurs.
The main symptoms of a pneumothorax are:
- Heart palpitations
- Lack of breath (dyspnea) and tiredness
- Sudden, sharp pain in the chest
- Cyanosis, which is the darkening of the body’s extremities and lips from lack of oxygen
In mediastinal tumor surgery, minimally invasive techniques are used to perform mediastinoscopy, a procedure that allows a detailed examination of the region to check for metastasis and also puncture material for biopsy. After the tumor has been identified and surgery is indicated, minimally invasive techniques will be used in procedures called VATS (Video-Assisted Thoracoscopy).