Tumors of the Pediatric Chest

Abstract

A wide spectrum of malignant and benign diseases can present in children as tumors involving the chest. Thoracic tumors are classified according to where they originate in the three major compartments within the chest, i.e., the lung parenchyma, mediastinum, and the chest wall. Lung tumors are relatively rare in children. The majority of mediastinal and chest wall tumors in children are malignant. The imaging evaluation of children with these tumors usually begins with a chest radiograph. Cross-sectional imaging with computed tomography (CT) and/or magnetic resonance imaging (MRI) allows narrowing of the differential diagnosis of pediatric chest masses by defining the origin and tissue characteristics. For pulmonary lesions seen on plain radiographs, the next imaging is usually CT, which may reveal endobronchial lesions, better define the lesion location, and detect additional lesions. Contrast-enhanced CT is also the primary cross-sectional imaging modality used for better definition of both the anatomic compartment of mediastinal mass and its relationship to vital structures. MRI is the preferred examination for evaluating possible intraspinal extension of a posterior mediastinal mass or of suspected vascular lesions