Mediastinal tumors - causes and symptoms Mediastinal tumors

Neoplasms are divided into those that primarily arise in the mediastinal zones, as well as those that are metastases already outside the mediastinum. By the nature of their origin, mediastinal tumors are divided into the following groups:

• Neurogenic;
• Mesenchymal;
• Lymphoid;
• Dysembryogenetic;
• Swollen in the thymus gland.

Sometimes pseudotumors are also observed, which are enlarged formations of lymph nodes in the case of tuberculosis, aneurysms. Additionally, true cysts are distinguished - pericardial, bronchogenic, enterogenic.

The most common types of tumors:

• Lymphomas;
• Thymomas;
• Retrosternal goiter;
• Mesenchymal tumors;
• Teratomas;
• Pericardial and bronchogenic cysts;
• Enterogenic cysts;
• Neurogenic tumors.

Causes

Most tumors are congenital, but begin to progress in adulthood.

Thus, teratomas arise due to a violation of the migration of cellular elements at the time of embryonic development and formation of the mediastinum. And neurogenic tumors are caused by disturbances in the embryonic development of the autonomic nervous system.

Symptoms

Tumor development is initially asymptomatic. Depending on the location of the neoplasm and its size, growth rate, and the options for interrelations with surrounding organs, the onset of the period of pronounced symptoms is determined. The nature of the tumor is also of great importance - benign or malignant.

The most common case of tumor detection is during preventive fluorography.

With further development of the formation in the mediastinum, the following groups of symptoms arise: general and specific, signs of compression of organs, sometimes - germination into organs and tissues.

In the early stages, tumors manifest themselves as pain in the chest due to compression (squeezing) or invasion (germination) into the plexus of nerves or nerve trunks. The pain is quite intense, but moderate, can radiate to the neck, shoulder, between the shoulder blades.

With the development of tumors in the left part of the mediastinum, the pain can coincide with angina pectoris. If the border sympathetic trunk is subject to compression, the following manifestations are observed:

• Enophthalmos;
• Miosis;
• Anhidrosis;
• Ptosis of the upper eyelid;
• Hyperemia on the affected side of the face.

If pain is experienced in the bones, this may be a sign of metastases.

Due to compression of the venous trunks, the process of venous blood outflow from the head, as well as the body in its upper half, is disrupted. The patient experiences noise in the head, chest pain, headache. A bluish tint is noticeable on the face, edema covers not only the face but also the chest, the veins of the neck swell, and central venous pressure increases.

If the trachea is compressed, the following symptoms occur:

• Shortness of breath;
• Cough;
• Stridor breathing.

With compression of the esophagus, dysphagia is observed, and the laryngeal nerve - dysphonia.

There are also general symptoms with the development of tumors mediastinum:

• Arrhythmia;
• Tachycardia;
• Pleurisy;
• Fever;
• Weight loss.

These symptoms are most relevant in the malignant development of neoplasms.

There are a number of specific symptoms that appear depending on the specific type of tumor:

• Skin itching and sweating at night - malignant lymphomas;
• Spontaneous decrease in blood glucose levels - fibrosarcoma;
• Arterial hypertension due to increased production of adrenaline and norepinephrine - neuroblastomas, ganglioneuromas;
• Thyrotoxicosis - thyrotoxic goiter;
• Myasthenia (50% of patients) - thymoma.

Diagnostics

To obtain the most accurate diagnosis, you need to make an appointment with a pulmonologist, as well as undergo a consultation with a thoracic surgeon. However, even a detailed study of the anamnesis and an objective examination do not allow us to determine the type of formation and its nature with sufficient reliability.

Therefore, instrumental methods of treatment are the most effective.

• Comprehensive X-ray of the chest and esophagus - determining the localization of the neoplasm, its shape, size, and the extent of the tumor process;
• Computer tomography of the chest, MRI - clarifying the data obtained during an X-ray examination;
• Mediastinoscopy, bronchoscopy, videothoracoscopy - confirmation or exclusion of bronchogenic localization of neoplasms, their germination into the trachea and large bronchi;
• Puncture biopsy - obtaining a sample of pathological tissue for morphological studies;
• (Sometimes) Parasternal biopsy - taking a sample mediastinum;
• Prescalene biopsy – used when lymph nodes in the supraclavicular region are enlarged;
• Bone marrow puncture – used when lymphoid tumors are suspected.

Treatment

Tumors are removed immediately to avoid complications such as organ compression, growth, or transformation into a malignant neoplasm. Thorascopic or open removal methods are usually used.

If the patient suffers from somatic diseases, transthoracic ultrasound aspiration can be used. Chemotherapy is prescribed taking into account the specific type of neoplasm.

Prevention

It is necessary to undergo diagnostic procedures regularly, first of all, fluorography and chest X-ray, which will help prevent complications and detect the tumor in time.