Obstruction, Perforation, Infection, and Haemorrhage in Thoracic Cancer

Abstract

Several different primary or secondary malignancies cause significant, even life-threatening, obstruction of intrathoracic organs or structures. The lumen of hollow organs may be occluded by malignant invasion, or by external compression by malignancies, e.g. in the upper mediastinum. These obstructions may be single or multiple; there may be tracheal and oesophageal obstruction in addition to a superior vena cava syndrome. Mediastinal cancer in particular may lead to obstructions, with symptoms and signs such as stridor and dyspnoea, dysphagia, oedema, cyanosis and petechial haemorrhages. The aggressive types of thymic tumours or teratomas causing the obstructions should be surgically removed, and postoperative radiotherapy and chemotherapy may be needed. Lymphomas causing multiple obstructions should be treated with radio- and chemotherapy. The different obstructions and their common causes are presented under separate subheadings.