Neoplasms are abnormal growths of tissue that can occur in almost any area of the body. They are also called tumors. They are most commonly linked with cancer. Tumors can develop in the mediastinum.
The mediastinum is the area in the middle of the chest that lies between the sternum (breastbone) and the spinal column. It contains vital organs including the heart, esophagus, and trachea. Tumors that develop in this area are called mediastinal tumors. These tumors are very rare.
Mediastinal tumors can develop in one of three areas of the mediastinum: the anterior (front), the middle, or the posterior (back). The position of the tumor in the mediastinum typically depends on the age of the patient.
Children are more likely to develop these tumors in the back of the mediastinum. They are often benign (non-cancerous). Adults are more likely to develop them in the front of the mediastinum. These tumors are typically malignant (cancerous). Adults that develop these types of tumors are usually between the ages of 30 and 50.
There are a number of different types of mediastinal tumors. The cause of these tumors is directly linked with where they form in the mediastinum.
In the front of the mediastinum, tumors can be caused by:
- lymphoma, including Hodgkin’s disease and non-Hodgkin’s lymphoma
- thymoma and thymic cyst—a tumor of the thymus
- thyroid mass mediastinal—generally a benign growth, but can sometimes be cancerous
In the middle of the mediastinum, tumors can be caused by:
- bronchogenic cyst—a benign growth that starts in the respiratory system
- lymphadenopathy mediastinal, or enlargement of the lymph nodes
- pericardial cyst—a benign growth on the heart lining
- thyroid mass mediastinal
- tracheal tumors—usually benign growths
- vascular complications, such as swelling of the aorta
In the back of the mediastinum, tumors can be caused by:
- extramedullary haematopoiesis—rare growths that start in the bone marrow and are related to severe anemia
- lymphadenopathy mediastinal
- neuroenteric cyst mediastinal—a rare growth involving both the nerves and the gastrointestinal system
- neurogenic neoplasm mediastinal—the most common case of posterior mediastinal tumors, they are cancerous cells of the nerves. According to the Cleveland Clinic Foundation, about 70 percent of these are benign (Cleveland Clinic).
Tumors that form in the mediastinum are known as primary tumors. Sometimes mediastinal tumors will develop because cancer from another part of the body has spread. The spread of cancer from one area of the body to another is known as metastasis. Mediastinal tumors that develop because of metastasis are known as a secondary tumor.
If you have a mediastinal tumor, you may not have any symptoms. Tumors are typically discovered during a chest X-ray performed to diagnose another health condition.
If symptoms develop, it is often because the tumor is pushing on surrounding organs. Symptoms can include:
- shortness of breath
- chest pain
- night sweats
- coughing up blood
- unexplained weight loss
- swollen lymph nodes
- respiratory blockage
If you have symptoms of a mediastinal tumor, your doctor will order additional tests to confirm your diagnosis. These tests may include:
- a chest X-ray
- a CT scan of the chest
- an MRI of the chest
- a mediastinoscopy with biopsy
Mediastinoscopy with biopsy is used to collect cells from the mediastinum. During this test, you will be given anesthesia. Your doctor will make a small incision (cut) under the breastbone. A sample of tissue will be removed. The sample will be analyzed to see if cancer is present. This procedure will help your doctor accurately diagnose the type of tumor you have.
Treatment for mediastinal tumors will depend on their location. Surgery is often used first to remove the tumor. Once the tumor is removed, chemotherapy and/or radiation therapy are used to destroy remaining cancer cells.
Both benign and malignant tumors require treatment. Non-cancerous tumors can grow and impact organ function. Cancerous tumors can spread to other areas of the body.
The specific type of treatment that you receive will be determined by your doctor.
If left untreated, mediastinal tumors can cause serious health complications. As tumors grow, they will push against surrounding organs and tissues. Tumors that invade the heart or the vessels of the heart can cause death.
Tumors may also invade the spinal column. This may result in compression of the spinal cord.
Treatment for this condition typically involves chemotherapy and radiation. Both treatments can have serious side effects, such as:
- changes in appetite
- bleeding problems
- hair loss
Radiation therapy may have similar side effects. Radiation may also cause changes in the skin, including:
The outlook for patients with mediastinal tumors depends on the location of the tumor. Long-term outlook also depends on if the tumor is primary or secondary. Talk to your doctor to get more accurate information about your prognosis.