What is a mediastinal tumour?

Mediastinal tumours are a type of cancer that develops in the area of the middle of the chest (mediastinum) between the sternum, spine and the lungs. This cancer usually forms as abnormal tumorous growths.

Where do mediastinal tumours develop?

Mediastinal tumours and develop in one of three areas of the mediastinum and usually depend on your age:

• The anterior (the front part)
• The middle
• The posterior (the back part)

Children can develop these tumours in the back of the mediastinum but are often non-cancerous. Adults, however, can develop them at the front and they are more typically cancerous.

What causes mediastinal tumours?

If cancerous tumours develop in the mediastinum, they are known as primary tumours. Mediastinal tumours can sometimes be caused because cancer has spread from another part of the body which are known as secondary tumours. The ultimate cause depends on where they develop.

Anterior — tumours can be caused by:

• Lymphoma, including Hodgkin’s disease and non-Hodgkin’s lymphoma
• Thyroid mass mediastinal. This is usually benign but can be cancerous
• Thymoma and thymic cyst, which is a tumour of the thymus - a primary lymphoid organ of the immune system

Middle — tumours can be caused by:

• Bronchogenic cysts which are abnormal growths of tissue that begin in the respiratory system
• Pericardial cysts, also known as clear water cysts, are benign growths that develop on the lining of the heart
• Tracheal (windpipe) tumours: these are usually benign growths
• Enlargement of lymph nodes
• Complications occurring in the vascular system such as swelling of the aorta - the artery that carries blood away from the heart

Posterior — tumours can be caused by:

• Extramedullary haematopoiesis (EH), which are growths that begin in the bone marrow
• Lymphadenopathy mediastinal, these are enlarged lymph nodes
• Neurogenic tumours, which are cancerous from cells in the nervous system
• Cystic mediastinal masses, which involves a growth in the nerves and gastrointestinal system

What are the symptoms of a mediastinal tumour?

Approximately, one-third of patients who have a mediastinal tumour doesn’t show any symptoms. The symptoms that do occur are usually due to the pressure put on the structure of the chest. The most common symptoms include:

• A cough
• Chest pain
• Fever/chills
• Haemoptysis (coughing up blood)
• Hoarseness
• Difficulty breathing
• Cold sweats

How is it diagnosed?

To diagnose a mediastinal tumour, you will need to undergo some tests which include

• A chest X-ray
• CT scan
• MRI scan
• An analysis of your blood to help determine the type of tumour
• A mediastinoscopy with biopsy

How is it treated?

The treatment depends on the location. The first line of treatment is usually surgery to remove the tumour. After this, you may need to undergo chemotherapy and radiotherapy.

Which specialist treats mediastinal tumours?

The type of specialist that treats mediastinal tumours may be either a thoracic surgeon, pulmonologist or an oncologist. They may also work together as part of a multidisciplinary team to provide you with the best treatment.