What is the mediastinal tumor?

What is the mediastinal tumor?  How to treat it?

A 20-year-old boy, has repeatedly coughed in the past half a month, but he has not noticed any improvement in anti-infection treatment, but has shortness of breath. Go to the hospital for examination, chest X-ray suggests that the left posterior mediastinum may be tumor, CT examination confirmed that it is a huge left posterior mediastinum mass, surrounding the aorta and left bronchus, the tumor is up to 10 cm in diameter!

What is a mediastinal tumor? How to treat it?

The position of the mediastinum is a bit unfamiliar to many people. The mediastinum is actually a gap. The front is the sternum, the back is the thoracic spine, the neck is connected to the upper part, and the lower is stopped at the septal muscles. Between the left and right lungs, it is generally the middle of the chest. Area. There are heart, great blood vessels, esophagus, trachea, nerve, thymus, thoracic duct, abundant lymphatic tissue and fatty connective tissue in the mediastinum.

In order to facilitate the anatomical positioning of mediastinal lesions, the mediastinum is usually divided into several parts. The most common method of dividing the mediastinum in clinical practice is the “quadrant method”, that is, dividing the mediastinum into upper and lower parts based on the horizontal line between the sternal angle and the lower edge of the fourth thoracic vertebra. The last three parts.

Since there are many tissues and organs in the mediastinum, there are many types of mediastinal tumors. Mediastinal tumors can also be divided into benign and malignant. The benign is more common, but a considerable part of it is malignant.

Benign mediastinal tumors include retrosternal goiter, mediastinal cyst, benign thymoma, neurogenic tumor, benign teratoma, mediastinal lipoma, mediastinal lymphangioma, etc.

Malignant mediastinal tumors include:

• malignant thymoma,
• hymic carcinoma,
• euroblastoma,
• eminoma,
• malignant teratoma,
• choriocarcinoma,
• leiomyosarcoma,
• skeletal sarcoma,
• lymphoma, etc.

01 Thymus tumor

Thymoma is located in the anterior superior mediastinum and is more common in young people. Most of them are benign, some of them have myasthenia gravis. Thymic cancer occurs in middle-aged and elderly people.

02 Neurogenic tumor

Most of them originated from the sympathetic nerves, and a few originated from the peripheral nerves. Most are benign, a few have malignant behavior.

03 Reproductive tumor

Reproductive tumors originate from germ cells and are mostly located in the anterior mediastinum. They can be divided into epidermoid cysts, dermoid cysts and benign teratomas.

04 Mediastinal cyst

The more common bronchial cysts, esophageal cysts and pericardial cysts are benign, with clear borders.

Mediastinal tumors tend to occur in young people with good health and strong tolerance. The symptoms are related to the size, location, growth rate, and nature of the tumor. Benign tumors grow slowly and often have no obvious symptoms. Once symptoms appear, the tumor is often very large. Malignant tumors are highly aggressive and progress rapidly.

Compression of nerves: Horner syndrome occurs when the sympathetic trunk is compressed, hoarseness occurs when the recurrent laryngeal nerve is compressed, upper arm numbness occurs when the brachial plexus is compressed, pain in the scapula area, and radiation pain in the upper limbs, and diaphragmatic paralysis may occur when the septal nerve is compressed.

Compression of the trachea or lungs: it can cause severe coughing, paroxysmal sputum, etc. The sputum volume is small and the texture is thick. As the disease progresses, chest tightness, shortness of breath, and even cyanosis may occur.

Compression of the esophagus: can cause difficulty swallowing.

Compression of blood vessels: Compression of the superior vena cava may include swelling of the face and upper limbs, and swelling of the superficial jugular vein.

Specific symptoms: coughing up hair-like fine hairs or bean curd-like sebum is caused by teratomas that break into the bronchus; the masses move up and down with swallowing as retrosternal goiter; those with myasthenia gravis are thymoma, etc., which are more meaningful for diagnosis Big.

Once mediastinal tumors are discovered, surgery is generally required. Traditional thoracotomy requires sawing the breastbone or biting the ribs, which is traumatic, painful and slow to recover. There are many postoperative complications, and the long incision also left unsightly scars on the patient’s chest. Minimally invasive thoracoscopic surgery that has been widely carried out in recent years has greatly improved the operation.

Minimally invasive thoracoscopic surgery only needs to open 1 to 3 small openings in the chest wall after general anesthesia, and clearly display the situation in the chest cavity on the TV screen through the lens that extends into the small opening, and then separate and remove the tumor with special equipment, with positioning Accuracy, less trauma, and less pain.

If the result of the tumor examination is benign after the operation, there is no special treatment after the operation, and only regular check-ups are required every year. If the result of the examination is malignant, further treatment is required.

(source:internet, reference only)

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