LIVRO A Simple Guide To Mediastinal Tumors Diagnosis, Treatment And Related Conditions (English Edition) PDF Kenneth Kee



Mediastinal tumors are the tumors that are found in the mediastinum.The mediastinum is the region in the middle of the chest that splits the lungs into right and left.Mediastinal tumors are benign or cancerous growths that form in the area of the chest that separates the lungs.The mediastinum is enveloped by the breastbone in front, the spine at the back, and the lungs on each side.The mediastinum contains the heart, aorta, esophagus, thymus and trachea.Mediastinum tumors are mostly made of:1. Reproductive (germ) cells or develop in2. Thymic (thymus),3. Neurogenic (nerve),4. Lymphatic (lymph) or5. Mesenchymal (soft) tissue.Generally, mediastinal tumors are rare. Mediastinal tumors are normally diagnosed in patients aged 30 to 50 years, but they can develop at any age and form from any tissue that is present in or passes through the chest cavity.The location of tumors within the mediastinum differs according to the age of the patient. In children, tumors are often found in the posterior (back) mediastinum. These mediastinal tumors often begin in the nerves and are normally benign (non-cancerous).In adults, most mediastinal tumors are located in the anterior (front) mediastinum and are normally malignant (cancerous) lymphomas or thymomas.SymptomsAlmost 50% of mediastinal tumors cause no symptoms.Most of the growths are often discovered on a chest x-ray that is done for another reason. When symptoms are evident they are often a due to pressure on (compression of) local structures, such as the spinal cord, heart or the pericardium (the heart’s lining), and may be:1. Chest pain2. Fever and chills3. Cough4. Coughing up blood (hemoptysis)5. HoarsenessDiagnosisA medical history and physical examination may show:1. Fever2. High-pitched breathing sound (stridor)3. Swollen or tender lymph nodes (lymphadenopathy)4. Unintentional weight loss5. WheezingFurther tests that may be done are:1. Chest x-ray 2. Computed tomography (CT) scan of the chest or CT-guided needle biopsy 3. Magnetic resonance imaging (MRI) of the chest4. Mediastinoscopy with biopsyMediastinoscopy with biopsy permits doctors to accurately diagnose 80 to 90% of mediastinal tumors, and 95 to 100% of anterior mediastinal tumorsTreatmentThe treatment used for mediastinal tumors is dependent on the type of tumor and its location:Germ cell tumors are normally treated with chemotherapy.Thymic cancers are treated with surgery.Types of surgery are thoracoscopy (a minimally invasive approach), mediastinoscopy (minimally invasive) and thoracotomy (a procedure done through an incision in the chest). Radiation or chemotherapy may be required additionally, dependent on the stage of the tumor and the success of the surgery.For lymphomas, chemotherapy is the treatment of choice, and may be followed by radiation.For neurogenic tumors of the posterior mediastinum, surgery is the main treatment.As compared with traditional surgery, patients who go through minimally invasive surgery, such as video-assisted thoracoscopy (VATS) mediastinoscopy, have:1. Decreased postoperative pain 2. Shorter hospital stay 3. More rapid recovery and return to work Other possible advantages are reduced risk of infection and less bleeding.There are complications in the use of radiation, chemotherapy and surgical treatment of mediastinal tumors.The possible complications of minimally invasive surgical treatment are:1. Damage to the surrounding area2. Pleural effusion3. Postoperative drainage 4. Postoperative infection or bleedingThe doctors will provide specific instructions to prepare the patient for each treatment or procedure.TABLE OF CONTENTIntroductionChapter 1 Mediastinal TumorsChapter 2 CausesChapter 3 SymptomsChapter 4 DiagnosisChapter 5 TreatmentChapter 6 PrognosisChapter 7 Cancer of LungsChapter 8 LymphomaEpilogue