Mediastinal and Chest Wall Tumors

Mediastinal tumors occur in the chest cavity, which contains the heart, large blood vessels, trachea (windpipe), thymus gland and connective tissues between the lungs. Chest wall masses in infants and children may be secondary tumors, or the result of a variety of other cancers that have spread. Primary mediastinal tumors include neuroblastomas and lymphomas.

The chest cavity is a common migration point for many secondary tumors. Liver, kidney, germ cell and other cancers may spread to the mediastinum, or the space between the sternum and the spine.

Cancers that originate in the chest wall are more rare, but are identified by the region affected.

• The anterior region is the area from the sternum to the front of the heart. Tumors of the anterior mediastinum can include mediastinal germ cell tumors, mediastinal lymphangioma (benign growth on lymphatic vessels), and thymic cysts (benign tumors on the thymic gland). Lymphangiomas and thymic cysts are removed in surgery and have excellent recovery rates.
• The middle mediastinal region includes the heart, aorta, trachea, bronchi and lymph nodes. The most common types of pediatric cancers in this region are lymphomas, Hodgkins and Non-Hodgkins lymphomas. Both are typically treated with radiation therapy and chemotherapy, but Non-Hodgkins lymphoma often requires a bone marrow transplant. There are dozens of types of specific Non-Hodgkins and Hodgkins lymphomas. The type and extent determines the treatment plan.
• The posterior region involves the space behind the heart to the spinal column. The most common posterior mediastinal tumor is the neuroblastoma. Other posterior tumors are not typically observed in pediatric patients.

Many factors affect recovery rate and treatment options:

• Size and removal of tumor
  Tumors that can be completely removed (resected) by a surgical treatment have a higher recovery rate. Chemotherapy may also be used to shrink the tumor for removal or to reach cancerous cells in other parts of the body. Generally, Wilms Tumors are more contained than other kinds of kidney tumors.
• Stage of tumor
  As with many cancers, Stage I and II tumors are more easily cured. The earlier the tumor is detected, the better chance for removal and treatment.
• Size and extent of tumor
  Especially with the two types of lymphoma, how far away from the lymph nodes the cancer has spread determines the treatment and recovery.

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