Mediastinal Tumors Health Article

Treatment

Doctors use surgery, radiation, and single-agent or combination chemotherapy to treat mediastinal tumors.

Thymomas

A patient whose thymoma is surgically removed (resected) has the best chance of survival. To lessen the likelihood of new tumors developing (reseeding), surgeons do not recommend biopsy, and try to remove the tumor without puncturing the capsule that encloses it.

RADIATION.

Thymomas respond well to radiation, which is used:

• to treat all stages of disease
• before or after surgical resection
• to treat recurrent disease.

The course of treatment lasts three to six weeks. The most common complications of radiation therapy are formation of scar tissue in the lungs (pulmonary fibrosis), inflammation of the pericardium (pericarditis), and inflammation of the spinal cord (myelitis).

CHEMOTHERAPY.

The use of chemotherapy to treat invasive thymomas is becoming more common. One or more drugs may be administered before or after surgery. Synthetic hormones (corticosteroids) can reverse the progression of tumors that do not respond to chemotherapy.

Teratomas

Teratomas are removed surgically. Chemotherapy and radiation are not used to treat these tumors. The prospect for long-term cure is excellent, and these tumors rarely recur.

Lymphomas

These tumors do not require surgery, except to make the diagnosis. Doctors treat them with chemotherapy and radiation.

Thyroid tumors

Doctors generally treat thyroid tumors with surgical resection, chemotherapy, and/or radiation.

Fibrosarcomas

Fibrosarcomas cannot usually be resected and do not respond well to chemotherapy.

Malignant schwannomas

Multiagent chemotherapy is used to treat these aggressive tumors, which tend to recur following surgery. The 5-year survival rate is 75%.

Neuroblastomas

Because these tumors sometimes regress spontaneously, doctors may postpone treatment if: the patient has no symptoms or the tumor is not growing.

In other cases, doctors remove these tumors even before symptoms appear. Risks associated with removing these tumors from the spinal canal include:

• injury to the spinal cord or anterior spinal artery
• uncontrolled bleeding in the spinal canal
• decreased blood supply (ischemia) to tissues and organs.

See Also CT-guided biopsy; Fibrosarcoma; Neuroblastoma; Thyroid cancer

Resources

BOOKS

DeVita, Vincent T., Jr., et al, eds. Cancer: Principles & Prac tice of Oncology. 5th ed. Philadelphia: Lippincott-Raven, 1997, pp. 951-967.

OTHER

Mullen, Brian F., et al. "Anterior mediastinal masses." Virtual Hospital. Copyright 1992-2001. <http://www.vh.org/Providers/Textbooks/LungTumors/PathologicTypes/Text/AnteriorMediastinalMasses.html>. 23 July 2001.

Maureen Haggerty