Mediastinal Tumors

Abstract

The evaluation and management of a mediastinal mass in a child presents a clinical challenge that requires thoughtful consideration. These masses often cause physiologic compromise due to compression of the central vascular, cardiac, or pulmonary structures. Pediatric patients are particularly susceptible to complications because of size limitations and, in some cases, rapid tumor growth. Physiologic compromise can be subtle with symptoms noted only upon careful review, while in other cases distress can be the presenting complaint. As some mediastinal lymphomas can double in size in less than 24 hours, these masses can present with rapidly progressing life-threatening symptoms. Moreover, even benign masses can exhibit life-threatening behavior when combined with anesthesia or surgery. As such, early and careful evaluation is imperative prior to diagnostic or therapeutic intervention. After an appropriate and detailed evaluation, most benign mediastinal tumors require surgical resection, while most malignant mediastinal masses require biopsy prior to definitive chemotherapy.