What is a Mediastinal Mass? Mediastinum Diagnosis and Treatment

The mediastinum is the name given to the region within the thoracic cavity, which is bounded by the sternum in the front, the vertebrae in the back, the lungs on the sides, and contains the heart, great vessels, lymph nodes and nerve structures. Since there are many different tissues in this area, many different types and numbers of tumors are seen. Although mediastinal masses can be seen in any age group, they are most common in the 20-30 age group and in men.

What are Mediastinal Cysts and Tumors?

Because there are many different tissues in the mediastinum, mediastinal masses may form as cysts or tumors. Their origins may differ due to tissue diversity.
Cysts seen in the mediastinum are very diverse. Fluid-filled cysts are usually benign. Cystic formations cause complaints in the patient only when they create strong pressure on the surrounding tissue. It can be in the form of esophageal cysts. Some of the mediastinal tumors are benign and some are malignant, as in the cyst. As the surrounding tissue, the trachea or vessel compresses the nerve bundles and creates clinical findings.
The most common mediastinal tumors are;

• Thymoma
• Lymphoma
• Nerve sheath tumors.

In addition to these tumor types;

• Germ cell tumors
• Thymic carcinoid and carcinomas
• Teratoma
• Hamartoma
• Tumors such as neuroblastoma can be seen.

In some patients, sarcoidosis disease may also involve the mediastinum.

What are the Symptoms of Mediastinal Masses (Cysts or Tumors)?

On average 50% of mediastinal masses are anterior, the rest is posterior and middle mediastinum. The most common thymoma, lymphoma and germ cell tumor in the anterior mediastinum; neurogenic tumors, bronchogenic cysts, enteric cysts in the posterior mediastinum; bronchogenic cysts, pericardial cysts and lymphomas in the middle mediastinum.
The most common symptoms are;

• chest pain,
• cough
• shortness of breath.

How to Diagnose Mediaten Masses? How Are They Treated?

Diagnosis can be made by direct thorax radiographs.
Preoperative computed tomography to determine the structure, localization and relationship of the mass with surrounding tissues after lung X-ray afi (CT) and magnetic resonance imaging (MRI) are performed.
Mediastinal masses are surgically removed.
Early surgical intervention should be performed because histopathological examination is required for accurate diagnosis of mediastinal masses and because benign masses have the potential to transform into malignant tumors.
Appropriate surgery depends on the location and extent of the mass.
There is no need for preoperative preoperative biopsy for thymomas, benign teratomas, cysts and neurogenic tumors. These masses can be removed directly.
If there is a malignant mass, adjuvant treatments (with additional methods) are planned after surgery.

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