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mediastinal neoplasm

Etiology: 1) anterior compartment a) more than 50% of mediastinal tumors are located in the anterior compartment b) thymoma (most common) c) lymphoma - Hodgkin's disease - non-Hodgkin's lymphoma d) germ cell tumors, teratoma e) thyroid neoplasm 2) middle compartment* a) cystic neoplasms - bronchogenic cyst - pericardial cyst - esophageal duplication cyst b) metastatic tumors (25%) c) lymphadenopathy is the most common cause of middle mediastinal mass [2] 3) posterior compartment a) 25% of mediastinal tumors b) nerve sheath tumors (70%) - schwannoma (neurilemoma) most common in adults - neurofibroma c) esophageal neoplasm or cyst d) malignant neoplasms are uncommon in the posterior mediastinum (< 4%) * lymphadenopathy is the most common mass in medial mediastinum secondary to lymphoma, sarcoid or metastatic malignancy Epidemiology: - 30% of mediastinal masses are malignant neoplasms Clinical manifestations: - may be asymptomatic - cough - venous distension - hoarseness - back pain - chest pain Radiology: - chest CT - MRI of thorax Differential diagnosis: - anterior compartment a) hematoma b) aortic aneurysm c) thyroid Management: - surgical removal if symptomatic or diagnosis in question [2]

Related

germ cell neoplasm lung cancer lymphoma (lymphosarcoma) mediastinum neurofibroma schwannoma (neurilemoma, neurinoma) thymoma

Specific

benign mediastinal neoplasm malignant mediastinal neoplasm secondary mediastinal neoplasm

General

neoplasm; tumor mediastinal disease (diseases of the mediastinum)

References

  1. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 774
  2. Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 2009, 2012, 2015, 2018, 2022. - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  3. Duwe BV, Sterman DH, Musani AI Tumors of the mediastinum. Chest. 2005 Oct;128(4):2893-909. PMID: 16236967
  4. Ponce FA, Killory BD, Wait SD et al Endoscopic resection of intrathoracic tumors: experience with and long-term results for 26 patients. J Neurosurg Spine. 2011 Mar;14(3):377-81 PMID: 21250809
  5. Takahashi K, Al-Janabi NJ. Computed tomography and magnetic resonance imaging of mediastinal tumors. J Magn Reson Imaging. 2010 Dec;32(6):1325-39. Review. PMID: 21105138
  6. Strollo DC, Rosado de Christenson ML, Jett JR. Primary mediastinal tumors. Part 1: tumors of the anterior mediastinum. Chest. 1997 Aug;112(2):511-22. Review. PMID: 9266892