What is the Location of Mediastinum In Our Body?

It is the area containing the heart, big blood vessels, lymph node stations and nerve structures, which is bordered by the reverse side of the breastbone in the thoracic cavity in front, the spine in back, and the lungs on each side. Since there is a great number of different tissues in this area, a great variety of tumors and cysts are seen there.

What are Mediastinal Tumors?

The most common tumors are thymoma, nerve sheath tumors, and lymphomas. Besides these, some rare tumors such as germ cell tumors, hamartomas, thymic carcinoid, thymic carcinomas, teratomas, neuroblastomas, and sarcoidosistumors may be seen, as well. In some cases, the thyroid tissue may grow and extend towards the mediastinum.

The photos below show the MR image of our patient with anterior mediastinal teratoma, and the teratoma mass that we surgically removed.

mediasten ameliyatı tümör çıkarılması
mediastende tümör görülmesi

Some of mediastinal tumors are benign while some others are malignant. They generally cause complaints by creating pressure on the blood vessels around them as well as on the trachea or nerve structures.

The following photo shows the front mediastinal tumor that we surgically removed from our 61-year-old female patient.

tümörün mediastenden çıkarılması
mr görüntüsünde mediasten tümörü görülmesi

Thymomas constitute one of the most common types of mediastinal tumor.

What are Mediastinal Cysts?

mediasten kisti görülmesiSome formations such as bronchogenic cysts, thymic cysts, pericardial cysts, esophageal cysts may be seen.These formations filled with fluid are generally benign. Because cystic formations do not often create a strong pressure, they do not cause significant complaints from patients.The following tomography shows the posterior mediastinal cystic lesion in our female patient. The result of postoperative pathology is in the form of a “bronchogenic cyst”. The cyst was removed with closed (endoscopic) intervention from this patient, who was discharged from the hospital 2 days later. The instructive operation video can be watched by clicking on the image.

What are the Mediastinal Treatment Methods?

Cystic diseases should be fully removed with an immediate surgery. As for tumors, they are either surgically removed or cured with chemotherapy and/or radiotherapy after the intervention intended for only diagnosis, depending on whether they are benign or malignant; as well as on their relations with the surrounding structures and the general condition of the patient. In some cases, all the treatment methods can be used in combination.

Why Should I Undergo a Surgery?

Surgery is needed for complete removal of the cyst or tumor in some cases, and sometimes for only diagnosis. Surgical intervention becomes necessary for some reasons, such as the elimination of the conditions that the tumor or cyst causes by creating a pressure; and the prevention of the spread of a malignant tumor in the body.

What do the International Sources Recommend?

  • Macchiarini P, Ostertag H (February 2004). “Uncommon primary mediastinal tumours”. Lancet Oncol. 5 (2): 107–18. doi:10.1016/S1470-2045(04)01385-3. PMID 14761815.
  • Davis RD, Oldham HN, Sabiston DC (September 1987). “Primary cysts and neoplasms of the mediastinum: recent changes in clinical presentation, methods of diagnosis, management, and results”. Ann. Thorac. Surg. 44 (3): 229–37. PMID 2820323.
  • Kuo TT (2001). “Classification of thymic epithelial neoplasms: a controversial issue coming to an end?”. J. Cell. Mol. Med. 5 (4): 442–8. doi:10.1111/j.1582-4934.2001.tb00182.x. PMID 12067481. http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm.:pubmed&issn=1582-1838&date=2001&volume=5&issue=4&spage=442

What are the Mediastinal Surgery Methods?

One of the following 3 ways can be used for most of patients, depending on the location of the cyst or tumor, whether it is benign or malignant, and the age and general health condition of the patient.

Removal of the tumor by splitting the sternum