Mediastinum is not a well-known term. But when it is said that it is the so-called sleepy tissue in animals, it is the area behind the breastbone that comes to everyone's mind. Mediastinum is the general name of the space between the two lungs within the chest cavity.
In this space, the heart, large vessels, trachea, esophagus, some nerve pathways, lymph nodes, fatty tissue and thymus, popularly known as sleepiness, are located. gland.
Which are the most common mediastinal tumors?
Tumors arising directly from mediastinal tissues are rare. The most common tumors are those that occur when lung cancer spreads to the lymph nodes. For example, small cell lung cancer most often spreads to the mediastinal lymph nodes. Additionally, squamous cell cancer may spread to the mediastinal lymph nodes. Apart from this, lymphomas (lymph cancers) are the most common tumors in the middle mediastinum. When we move to the posterior region, tumors originating from the nerve chain are seen. These are generally benign in character. The most common type is ganglioneuromas.
When we come to the front, thymomas (thymus tumors) are common.
Apart from this, problems that occur in the progression of cells during the development of the baby can manifest themselves as tumors in later ages, such as germ cell tumors in young men or teratomas in women.
What complaints do these patients have? Do they apply?
Small tumors are usually found incidentally. When lung cancers or other mediastinal tumors grow and put pressure on large vessels, a condition called superior vena cava syndrome may occur, in which the face and neck swell and the vessels become prominent. Lymphoma patients often experience fatigue, weight loss, fever and night sweats. Nerve-derived tumors, which we call neurogenic tumors, usually do not cause any symptoms until they become very large. Thymomas and other tumors located in the anterior mediastinum region do not cause many symptoms unless they reach very large sizes.
What examinations are performed?
The disease is usually noticed on a chest x-ray. immediate contrast-enhanced computed tomography of the thorax (t sickle CT) is taken. Then, in some cases, magnetic resonance (MRI) is performed to clearly reveal the vascular extension. In germ cell tumors located in the anterior region, beta-HCG and alpha-fetoprotein tests are performed on the blood to decide the origin of the tumor.
How is it diagnosed?
Extension to the mediastinum. In cases of lung cancer that show signs of cancer, the results are usually obtained by taking samples with bronchoscopy (examination of the inside of the trachea with a light tube) and endobronchial ultrasonography (ultrasound analysis inside the trachea). Tumors in the anterior region can be diagnosed with thick needle (trucut) biopsy accompanied by tomography. In cases where it cannot be placed, the result is obtained by removing the part with the closed chest surgery method, which we call VATS.
What is the Treatment for Mediastinal Tumors?
Treatments vary depending on the tumor type. The treatment method for lung cancers that extend to the mediastinum or have spread to the lymph nodes is either preoperative (neoadjuvant) chemotherapy or chemoradiation alone. Thymomas are removed by surgery if they are not very large and there is no vascular involvement. The same applies to teratomas and neurogenic (nerve origin) tumors. Sometimes tumors of nerve origin extend to the spinal cord and may require joint surgery with neurosurgery.
In germ cell tumors, chemotherapy and sometimes surgery are applied together depending on the cell type.
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