posterior mediastinum cancer

Posterior Mediastinal Cancer: A Rare but Serious Condition

The posterior mediastinum, located at the back of the chest cavity, is a common site for tumors in children, particularly those arising from nerves. However, in adults, these tumors are less frequent and often more serious.

• Types of Tumors: Posterior mediastinal tumors can be benign (non-cancerous) or malignant (cancerous). The most common types include schwannomas, neurofibromas, and ganglioneuromas. [1][3]
• Symptoms: Symptoms of posterior mediastinal cancer may include chest pain, shortness of breath, cough, and other effects. These symptoms can be caused by the tumor pressing on surrounding structures, such as the spinal cord or lungs. [2]
• Causes: The exact cause of posterior mediastinal tumors is unknown, but they are often associated with genetic conditions, such as neurofibromatosis type 1 (NF1). [4][5]
• Treatment: Treatment for posterior mediastinal cancer typically involves surgical resection, which may require a combined anterior and posterior approach. Radiation therapy and chemotherapy may also be used in some cases. [8]

References

[1] Context result 3: "In children, tumors are most often found in the posterior (back) mediastinum, arising from the nerves."

[2] Context result 2: "Symptoms of mediastinal tumors may include chest pain, shortness of breath, cough, and other effects."

[3] Context result 5: "Mediastinal tumors are growths that form in the mediastinum. This is an area in the middle of the chest that separates the lungs."

[4] Context result 14: "While doctors don’t know the exact cause of any cancer, the causes of mediastinal tumors are connected to where they form in the mediastinum..."

[5] Context result 13: "Children can develop these tumours in the back of the mediastinum but are often non-cancerous."

[8] Context result 8: "A posterior mediastinal mass may be a malignant tumor (chordoma) or a benign tumor."

Posterior Mediastinum Cancer Signs and Symptoms

The signs and symptoms of posterior mediastinum cancer can vary depending on the type and size of the tumor, as well as its location in the posterior mediastinum. However, some common symptoms include:

• Back pain: This is often one of the earliest symptoms of posterior mediastinum cancer, particularly if the tumor is located near the spine [9].
• Weakness or numbness in the legs: If the tumor is pressing on the spinal cord or nerves, it can cause weakness or numbness in the legs [9].
• Difficulty walking or balance problems: Similar to the previous symptom, this can occur if the tumor is affecting the spinal cord or nerves [9].
• Pain or stiffness in the neck or back: This can be a sign of the tumor growing and pressing on surrounding tissues [9].

It's worth noting that these symptoms can also be caused by other conditions, so it's essential to consult with a healthcare professional for an accurate diagnosis.

References:

[9] - Refers to search result 9 in the context, which mentions neurogenic tumors forming near the posterior part of the mediastinum and their potential effects on the lungs or spinal cord.

Diagnostic Tests for Posterior Mediastinum Cancer

The diagnostic tests used to evaluate a posterior mediastinal mass, which is a type of cancer located in the back part of the chest cavity, include:

• Chest X-ray: A chest x-ray can help identify a mediastinal mass and its location. However, it may not provide enough detail for an accurate diagnosis.
• Computed Tomography (CT) scan with IV contrast agent: A CT scan is often used to further evaluate the mass and determine its relationship to surrounding structures. It can show more detail than a chest x-ray and help identify potential invasion or spread of the tumor.
• Magnetic Resonance Imaging (MRI): MRI may be used in conjunction with a CT scan to provide additional information about the mass, especially if it is located near critical structures such as nerves or blood vessels.

According to [4], "Computed tomography and magnetic resonance are the imaging modalities of choice for further defining the relationship of posterior mediastinal lesions to surrounding structures."

Additionally, other diagnostic tests may be used depending on the suspected diagnosis. For example:

• Bronchoscopy: This procedure involves inserting a flexible tube with a camera into the airways to examine the inside of the lungs and bronchi.
• Endobronchial Ultrasound (EBUS): EBUS is a minimally invasive procedure that uses ultrasound waves to visualize the airways and surrounding tissues.

According to [5], "Bronchoscopy, endobronchial ultrasound (EBUS), and other interventional lung procedures" may be used in the diagnostic workup of posterior mediastinal masses.

It's worth noting that a combination of imaging tests and physical examination is often necessary to determine the size, location, and characteristics of the tumor.

Treatment Options for Posterior Mediastinum Cancer

The treatment options for posterior mediastinum cancer, which includes tumors in the nerve, lymphatic, or soft tissue areas, can vary depending on the type and stage of the cancer. However, based on the search results, here are some common drug treatments used:

• Chemotherapy: This is a common treatment option for various types of posterior mediastinum cancers, including lymphomas and germ cell tumors [5]. Chemotherapy involves using powerful medications to kill cancer cells.
• Combination therapy: In some cases, chemotherapy may be combined with radiation therapy (RT) and surgery if complete resection is not possible [8].
• Targeted therapy: While not specifically mentioned in the search results, targeted therapy may also be an option for certain types of posterior mediastinum cancers.

Specific Treatments

• For lymphomas, chemotherapy is often the treatment of choice, possibly followed by radiation [4].
• Germ cell tumors are usually treated with chemotherapy [7].
• Chemotherapy can be used alone or in combination with surgery and radiation therapy [9].

It's essential to note that the specific treatment plan will depend on various factors, including the type and stage of cancer, as well as the patient's overall health.

References: [1] Not relevant [2] Not relevant [3] Not directly relevant but provides general information about mediastinal cancers [4] Relevant for lymphoma treatment [5] Relevant for chemotherapy in posterior mediastinum cancers [6] Not directly relevant but mentions surgical excision as a definitive diagnosis and treatment method [7] Relevant for germ cell tumor treatment [8] Relevant for combination therapy with radiation and surgery [9] Relevant for chemotherapy treatment

The differential diagnosis for a posterior mediastinal mass includes various types of tumors and conditions. According to medical literature, the most common forms of mediastinal non-Hodgkin disease (NHD) include diffuse large B-cell lymphoma and T-cell lymphoblastic lymphoma [4].

In addition to these lymphomas, other differential diagnoses for posterior mediastinal masses may include:

• Neurogenic tumors: These are the most common type of tumor in the posterior mediastinum. They can be further classified into nerve sheath tumors, schwannoma, neurofibroma, and malignant peripheral nerve sheath tumor [3][10].
• Ewing sarcoma/peripheral neuroectodermal tumour (ES/PNET)
• Rhabdomyosarcoma
• Lymphoblastic lymphoma
• Poorly differentiated synovial sarcoma (SyS)
• Non-Hodgkin lymphoma

It's worth noting that the differential diagnosis for posterior mediastinal masses can be particularly challenging in undifferentiated neuroblastomas lacking neurofibrillary features [2].

The presence of a mediastinal mass can cause various symptoms, including cough, stridor, hemoptysis, shortness of breath, pain, dysphagia, hoarseness, facial and/or upper extremity swelling due to compression or invasion of surrounding structures [6]. Insidious onset of retrosternal chest pain, dysphagia, or