Mediastinal masses: what are they?

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Mediastinal masses are tumors that can grow in the front of the chest and are associated with various cancers. Diagnosis requires tests, and treatment depends on the type of cancer. Sarcoma, thymoma, and lymphoma are the three types of cancer that can cause mediastinal masses. Diagnosis may require a physical exam, chest X-rays, blood work, and biopsy. Treatment may include surgery, radiation, chemotherapy, or bone marrow transplantation.

Mediastinal masses are tumors that develop in the front of the chest, the part of the human body that runs from the diaphragm to the neck. Tumors that can grow in this area are associated with a handful of cancers. Tumors discovered in the mediastinal compartment are more likely to be malignant than those found in other areas of the chest. Diagnosis generally requires a variety of tests. Treatment depends on which cancer is the root cause.

The anterior mediastinal compartment is the area between the front of the rib cage and the heart. Mediastinal masses caused by one of three types of cancer can develop in this compartment. The first is sarcoma. Sarcoma develops when tissue undergoes a malignant transformation into a tumor. There are many types of sarcomas depending on the tissue that gives rise to the tumor.

The second type of mediastinal mass that can grow into the mediastinal compartment is a thymoma. The condition presents as chest pain and coughing due to tumor growth applying pressure to the breastbone and lungs. Thymomas in their early stages are not malignant, although in rare cases they can become life-threatening if the tumor compresses the veins that enter the heart.

A number of tumors give rise to lymphomas, the latter type of mediastinal masses. Lymphomas start in the lymph nodes of the body. The cancer metastasizes to the mediastinal compartment. In addition to the symptoms described in the previous paragraph, a patient with lymphoma experiences weight loss, fever, and fatigue. By the time most cases are diagnosed, the cancer has already metastasized to a secondary location outside the chest.

Diagnosing mediastinal masses may require a number of tests: physical exam, chest X-rays, blood work, and biopsy. The last is a tissue sample taken from the mass through a minimally invasive surgical procedure. Through examination of the sample, a doctor can diagnose the specific form of cancer. X-rays and blood tests determine the stage of the cancer. With this information, a doctor can plot a course of treatment.

Depending on the type of tumor, a combination treatment including surgery, radiation, and chemotherapy may be needed to remove the tumor and kill any remaining cancer cells. Because thymomas are rarely malignant, surgical removal of the tumor is usually the only treatment required. Surgery is rarely used to treat lymphomas. Patients have to rely on chemotherapy and radiation. For some patients, bone marrow transplantation is the best treatment modality.




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