What Are Mediastinal Masses?

Mediastinal masses are tumors that develop at the front of the thorax, the part of the human body ranging from the diaphragm to the neck. The tumors that can grow in this area are associated with a handful of cancers. Tumors discovered in the mediastinal compartment are more likely to be malignant than those found in other areas of the thorax. Diagnosis generally requires a variety of tests. Treatment depends on which cancer is the root cause.

The anterior mediastinal compartment is the area between the front of the ribcage and the heart. In this compartment, mediastinal masses caused by one of three types of cancer can develop. The first is sarcoma. Sarcoma develops when a tissue undergoes a malignant transformation into a tumor. There are many types of sarcomas depending on which tissue gives rise to the tumor.

The second type of mediastinal masses that can grow in the mediastinal compartment is a thymoma. The condition presents as chest pain and cough due to the growing tumor applying pressure to the sternum and lungs. Thymomas in their early stages are not malignant, though in rare cases can become life-threatening if the tumor compresses the veins entering the heart.

A number of cancers give rise to lymphomas, the final type of mediastinal masses. Lymphomas begin in the body’s lymph nodes. The cancer metastasizes to the mediastinal compartment. Besides the symptoms described in the previous paragraph, a patient with a lymphoma experiences weight loss, fever and fatigue. By the time most cases are diagnosed, the cancer has already metastasized to a secondary location outside of the thorax.

Diagnosing mediastinal masses may require a number of tests: physical exam, chest x-rays, blood work and a biopsy. The last is a sample of tissue taken from the mass through a minimally invasive surgical procedure. Through examining the sample, a physician can diagnose the specific form of cancer. X-rays and blood work determine the cancer’s stage. With this information, a physician can plot a course of treatment.

Depending on the type of tumor, a combination treatment including surgery, radiation and chemotherapy may be necessary to remove the tumor and kill any remaining cancerous cells. As thymomas are rarely malignant, surgically removing the tumor is usually the only treatment required. Surgery is rarely used to treat lymphomas. Patients must rely upon chemotherapy and radiation. For some patients, a bone marrow transplant is the best mode of treatment.