Mediastinal tumor - symptoms in adults, classification, treatment. Mediastinal tumors: types, symptoms, modern methods of treatment What is heat of the anterior superior mediastinum

This type of disease is displayed as a tumor and cyst; the causes of the disease may depend on the age of the person and the location of the formation in the middle, posterior and anterior mediastinum. In this case, formations can be either asymptomatic, which most often appear in adults, or cause obstruction respiratory tract which is most common in children. At the time of diagnosis, CT was used, but other studies can be performed if necessary.

What can cause mediastinal masses?

Essentially, they are divided into special groups, and each of them has special characteristic formations. If we consider the anterior group, it is limited to the area of ​​the sternum, brachiocephalic vessels and pericardium. The middle group includes the location between the posterior and middle mediastinum. The posterior group is limited to the trachea and pericardium, and can also appear in the spinal region. As for children, often formations appear such as a cyst or tumor. As for adults, this includes thymoma and neutrogenic tumors. Lymphomas also occur, but only between the ages of 20 and 40.

Symptoms of mediastinal formation

In fact, the symptoms of the formation should depend only on the location, and asymptomatic ones are most common. Much more often accompanied by the development of clinical symptoms - malignant tumor compared to benign. Such symptoms manifest themselves as chest pain and decreased body weight. In childhood, symptoms appear when they cause compression of the bronchi and trachea, as well as stridor, pneumonia, and recurrent bronchitis. Formation anterior mediastinum when large, it causes shortness of breath when lying on your back. The middle mediastinum compresses the airways and blood vessels. As a result, this leads to the development of superior genital vein syndrome or airway obstruction. The posterior mediastinum compresses the esophagus and, as a result, grows into it. Ultimately, this can lead to the development of odynophagia or dysphagia.

Diagnosis of mediastinal formation

In some cases, space-occupying formations of the mediastinum may occur during radiography of organs in the area chest. It can also manifest itself in other radiation studies that are performed as clinical symptoms in the chest area. Additional diagnostic studies may also be carried out, and most often these are biopsy and radiation, which must be carried out in order to make it easier to determine the type of formation.

CT, which has intravenous contrast, is considered a more informative imaging method. It is possible to differentiate CT from other processes with a high degree of confidence in the area of ​​the chest of normal structure with a cyst or benign tumor. The correct diagnosis is established for various mediastinal formations, as a result of core needle biopsy and fine needle aspiration biopsy. Where fine needle aspiration biopsy is necessary for malignant processes if thymoma or lymphoma is suspected. With this process, it is necessary to do a core biopsy. If tuberculosis is suspected, then it is necessary to carry out tuberculin test. If ectopic tissue is suspected in the area thyroid gland it is necessary to conduct a study of the concentration of thyroid-stimulating hormone.

Treatment of mediastinal formation

The treatment itself will depend on the type of space-occupying formation; there are special benign formations, pericadral cyst, which can also be observed. Many malignant tumors must be removed only by surgery, but in special cases it is necessary to carry out chemotherapy. When granulomatous diseases manifest themselves, it is imperative to carry out adequate antimicrobial therapy.

Indications for surgical treatment

It is mandatory to perform surgical intervention when mediastinal neoplasms appear. Diseases such as sarcoma, carcinoid tumors and invasive thymoma will not be in doubt. But exceptions can be noted; these are mediastinal lymphomas, and for such treatment it is necessary to use chemoradiotherapy. Let's look at the indications for surgical treatment; it can be determined by the following circumstances.

First of all, it can be noted that any formation can manifest itself in a malignant form. And if you use conservative tactics in the absence of reliable morphological confirmation, this leads to invasion of vital structures and organs. For such a case, it is best to use a study of the surgical drug. Other methods will not bring complete confidence.

Every benign or malignant volumetric process that is displayed in a confined space contains a potential threat. Based on all the recommendations provided regarding indications for surgical treatment, the following points can be included. Any mediastinal formations, the histological diagnosis could not plausibly clarify the morphological diagnostic method. Malignant tumors with distant metastases are complicated by mediastinal compression, as well as any locally advanced and local formations, with the exception of mediastinal lymph nodes.

Considering that asymptomatic cysts or other benign formations will be absolutely harmless, they belong to non-surgical treatment. In this case, it is impossible to give consent from a conservative point of view, since a benign tumor and cyst are not as dangerous when considered in relation to organ compression syndrome compared to malignant neoplasms. There is a lot of information in the medical literature about various variants of mediastinal compression syndrome, which are caused by benign pathology.

Contraindications to surgical treatment

Considering that every extensive education involves risk dangerous complications for the patient’s life, then it is best to note here not only about contraindications to surgical treatment, but also about the principles for choosing the method of surgical aggression. Using modern surgical technology, it is possible to perform interventions of varying volumes, reconstruction and resection on many anatomical structures.

Mediastinal compression syndrome in various clinical variants can be considered not only a contraindication, but also a frequent vital indication in the field of surgical intervention. Wide abdominal interventions in the area of ​​mediastinal formation will be contraindicated if severe coronary, respiratory, renal, hepatic, or cerebral insufficiency manifests itself. Only if they are not associated with the formation of the mediastinum. If this happens, then the issue will need to be resolved individually.

Description:

Mediastinal neoplasms (tumors and cysts) account for 3-7% of all cancers. Most often, mediastinal neoplasms are detected in people 20-40 years old, i.e., in the most socially active part of the population. About 80% of detected mediastinal tumors are benign, and 20% are malignant.
The mediastinum is the part of the thoracic cavity bounded in front by the sternum, partially by the costal cartilages and retrosternal fascia, and behind by the anterior surface. thoracic the spine, the necks of the ribs and the prevertebral fascia, on the sides - the layers of the mediastinal pleura. The mediastinum is limited below by the diaphragm, and above by a conventional horizontal plane drawn through the upper edge of the manubrium of the sternum.
The most convenient scheme for dividing the mediastinum was proposed in 1938 by Twining - two horizontal (above and below the roots of the lungs) and two vertical planes(in front and behind the roots of the lungs). In the mediastinum, therefore, three sections (anterior, middle and posterior) and three floors (upper, middle and lower) can be distinguished.
In the anterior section of the superior mediastinum there are: the thymus gland, the upper section of the superior vena cava, the brachiocephalic veins, the aortic arch and its branches, the brachiocephalic trunk, the left common carotid artery, the left subclavian artery.
In the posterior part of the upper mediastinum there are: the esophagus, the thoracic lymphatic duct, the trunks of the sympathetic nerves, the vagus nerves, nerve plexuses organs and vessels of the chest cavity, fascia and cellular spaces.
In the anterior mediastinum there are: fiber, spurs of the intrathoracic fascia, the leaves of which contain the internal mammary vessels, retrosternal lymph nodes, and anterior mediastinal nodes.
In the middle section of the mediastinum there are: the pericardium with the heart enclosed in it and the intrapericardial sections of large vessels, the tracheal bifurcation and the main bronchi, pulmonary arteries and veins, phrenic nerves with accompanying phrenic-pericardial vessels, fascial-cellular formations, lymph nodes.
In the posterior part of the mediastinum there are: the descending aorta, azygos and semi-gypsy veins, trunks of sympathetic nerves, vagus nerves, esophagus, thoracic lymphatic duct, lymph nodes, tissue with spurs of the intrathoracic fascia surrounding the organs of the mediastinum.
According to the departments and floors of the mediastinum, certain preferential localizations of most of its neoplasms can be noted. Thus, it has been noticed, for example, that intrathoracic goiter is often located in the upper floor of the mediastinum, especially in its anterior section. Thymomas are found, as a rule, in the middle anterior mediastinum, pericardial cysts and lipomas - in the lower anterior. The upper floor of the middle mediastinum is the most common location of teratodermoids. In the middle floor of the middle part of the mediastinum, bronchogenic cysts are most often found, while gastroenterogenic cysts are detected in the lower floor of the middle and posterior parts. The most common neoplasms of the posterior mediastinum along its entire length are neurogenic tumors.

Symptoms:

Mediastinal neoplasms are found mainly in young and middle age (20 - 40 years), equally often in both men and women. During the course of the disease with mediastinal neoplasms, an asymptomatic period and a period of pronounced clinical manifestations can be distinguished. Duration asymptomatic period depends on the location and size of the neoplasm, its nature (malignant, benign), growth rate, relationship with organs and formations of the mediastinum. Very common mediastinal neoplasms long time are asymptomatic and are accidentally discovered during prophylactic x-ray examination chest.
Clinical signs of mediastinal tumors consist of:
- symptoms of compression or tumor growth into neighboring organs and tissues;
- general manifestations of the disease;
- specific symptoms characteristic of various neoplasms;
Most frequent symptoms are pains that arise as a result of compression or germination of a tumor into nerve trunks or nerve plexuses, which is possible both with benign and with malignant neoplasms mediastinum. The pain is usually mild, localized on the affected side, and often radiates to the shoulder, neck, and interscapular area. Pain with left-sided localization is often similar to pain with. If bone pain occurs, the presence of metastases should be assumed. Compression or germination of the borderline sympathetic trunk by a tumor causes the occurrence of a syndrome characterized by prolapse upper eyelid, pupil dilation and retraction eyeball on the affected side, impaired sweating, changes in local temperature and dermographism. Damage to the recurrent laryngeal nerve is manifested by hoarseness of voice, the phrenic nerve - by a high standing dome of the diaphragm. Compression spinal cord leads to spinal cord dysfunction.
A manifestation of compression syndrome is compression of large venous trunks and, first of all, the superior vena cava (superior vena cava syndrome). It manifests itself as a violation of the outflow venous blood from the head and upper half of the body: patients experience noise and heaviness in the head, worsening in an inclined position, chest pain, swelling and cyanosis of the face, upper half of the body, swelling of the veins of the neck and chest. Central venous pressure rises to 300-400 mmH2O. Art. When the trachea and large bronchi are compressed, shortness of breath occurs. Compression of the esophagus can cause dysphagia, an obstruction in the passage of food.
In the later stages of development of neoplasms, the following symptoms occur: general weakness, increased body temperature, sweating. weight loss, which are typical for. Some patients experience manifestations of disorders associated with intoxication of the body by products secreted by growing tumors. These include arthralgic syndrome, reminiscent of rheumatoid polyarthritis; pain and swelling of the joints. soft tissues of the extremities, increase in heart rate, cardiac arrhythmia.
Some mediastinal tumors have specific symptoms. Thus, night sweats are characteristic of malignant lymphomas (lymphogranulomatosis, lymphoreticulosarcoma). A spontaneous decrease in blood sugar levels develops with mediastinal fibrosarcomas. Symptoms of thyrotoxicosis are characteristic of intrathoracic thyrotoxic goiter.
Thus, clinical signs neoplasms, mediastinum are very diverse, however, they manifest themselves in the late stages of the disease and do not always allow an accurate etiological and topographic-anatomical diagnosis to be established. Data from radiological and instrumental methods are important for diagnosis, especially for recognizing the early stages of the disease.

Causes:

Treatment:

Treatment of neoplasms of the mediastinum is surgical. Removal of tumors and cysts of the mediastinum must be done as early as possible, as this is the prevention of their malignancy or the development of compression syndrome. The only exceptions may be small lipomas and coelomic cysts of the pericardium in the absence of clinical manifestations and a tendency to their increase. Treatment of malignant tumors of the mediastinum in each specific case requires an individual approach. Usually it is based on surgical intervention.
The use of radiation and chemotherapy is indicated for most malignant tumors of the mediastinum, but in each specific case their nature and content are determined by the biological and morphological characteristics of the tumor process and its prevalence. Radiation and chemotherapy are used in combination with surgical treatment, and independently. As a rule, conservative methods form the basis of therapy for advanced stages of the tumor process, when radical surgery is impossible, as well as for mediastinal lymphomas. Surgical treatment with these tumors can be justified only by early stages diseases when the process locally affects a specific group lymph nodes, which is not very common in practice. IN recent years A videothoracoscopy technique has been proposed and successfully used. This method allows not only to visualize and document mediastinal tumors, but also to remove them using thoracoscopic instruments, causing minimal surgical trauma to patients. The results obtained indicate the high effectiveness of this treatment method and the possibility of carrying out the intervention even in patients with severe concomitant diseases and low functional reserves.

A mediastinal mass is a neoplasm that develops in the mediastinal space of the chest. Moreover, it can be of various types in morphologically. The big picture of this disease is expressed in the form of symptoms of compression and germination of pathology into nearby organs. It is diagnosed through the use of X-rays, tomography, endoscopy, and transthoracic puncture (although aspiration biopsy can also be used). It can be treated only with surgical intervention; only in case of a malignant form, radiation and chemotherapy are additionally used.

Tumors, as well as cysts of the mediastinum of the lung, account for about 5% of all formations of this type. Most of them, 70%, are benign pathologies, the remaining 30% are malignant formations. This disease affects everyone, regardless of gender, whose age ranges from 20 to 40 years, in other words, the most active part of the population. These types of tumors have characteristic feature its great morphological diversity, as well as a high chance of initial malignancy or malignancy over time.

They can also lead to invasion or compression of organs important for human life located in the mediastinum, from the respiratory tract to the esophagus. The surgical removal procedure is extremely complex. This makes such pathologies one of the most difficult problems today in the field of thoracic surgery, as well as pulmonology.

Classification

As for the appearance of clinical manifestations of this disease, they are characterized by:

• Compression or invasion of nearby tissues and organs;
• Appearance common symptoms, as well as specific to a particular type.

First of all, regardless of the morphological nature of the disease, it manifests itself in the form pain, localized in the chest, which arise due to compression or due to the germination of pathology directly into the nerve plexuses. In this case, the pain will be of moderate strength and will radiate to the neck, shoulders and the area between the shoulder blades.

Massive formations of the mediastinum developing on the left side can cause pain similar to that that occurs with angina pectoris. When in this case there is compression or invasion of the nearby sympathetic trunk, this quite often leads to the development of Horner's symptom. If there is pain in the bones, then this situation often means the presence of metastases in them.

Compression of the venous trunks, as a rule, manifests itself in the form of superior vena cava syndrome. In this case, there is a disruption in the outflow of blood not only from the head, but also from the entire upper part of the body. This situation is characterized by the presence of heaviness, as well as noise in the head, severe pain in it, the appearance of shortness of breath, swelling of the face and chest. This also causes veins to swell cervical spine and the level of venous pressure increases.

When the bronchi or trachea are compressed, this leads to coughing and shortness of breath. General symptoms may include weakness, fever, tachycardia, arrhythmia and other manifestations. They most often appear in the presence of malignant ones.

In the case of the development of certain mediastinal tumors, specific symptoms appear. For example, in the presence of malignant lymphomas of increased size, there is excessive sweating and severe itching. Bulk fibrosarcoma leads to a sudden decrease in the amount of glucose in the blood.

Diagnostics

The greater variety of symptoms of this disease does not always allow doctors to identify a formation affecting the mediastinal space only according to medical history and external manifestations. Due to this, instrumental methods play the main role in diagnostics. Thus, with the help of a comprehensive x-ray examination, it is most often possible to accurately identify where exactly the tumor is located, what shape it has, size and how widespread it is.

The most important thing if a doctor suspects this pathology is to conduct an X-ray of the chest, esophagus, as well as polypositional radiography. To confirm or clarify the data obtained in this way, CT, MRI and MSCT of the lungs may also be prescribed.

The following methods are used as endoscopic examination methods:

1. Mediastinoscopy.
2. Videothoracoscopy.
3. Bronchospokia.

Thus, the implementation of the latter makes it possible to exclude the bronchogenic localization of the pathology, as well as its germination into the trachea or large bronchi. The method of transtracheal or transbronchial biopsy of the formation can also be used. Sometimes samples of abnormal tissue can be taken by performing a needle biopsy, which is carried out under close ultrasound guidance.

To obtain the materials necessary for morphological research, doctors prefer thoracoscopy, performed under visual control. Sometimes, in order to conduct an inspection and biopsy of the mediastinal space, a mediastinotomy is performed.

Treatment

To prevent formations from developing into a malignant form, as well as the development of compression syndrome, it is important to remove them as quickly as possible after detection. To do this, use either open method surgical intervention (laparotomy), or thoracoscopic. When the tumor is located in the retrothoracic region or has a bilateral location, a longitudinal sternotomy is used to eliminate it. And if the disease has an anterolateral localization, this allows it to be easily removed by thoracectomy.

If there is a severe general somatic background, transthoracic ultrasound aspiration is recommended. When a malignant form of the disease is present, it is carried out surgical removal tumors of the extended type or palliative, to prevent decompression of organs located in the mediastinum.

In the section on diseases of the mediastinum, usually only diseases of the lymph nodes, tissue, and partly the mediastinal pleura are considered, mainly from the point of view of the compression phenomena they cause; purulent mediastinitis is primarily of surgical interest.
When considering the symptoms of compression, it is advisable to conditionally divide the mediastinum (minus the main organs - the heart and cardiac membrane) into upper, posterior, anterior. The upper mediastinum contains the aortic arch, thoracic (lymphatic) duct, esophagus, vagus, sympathetic, phrenic nerve; posterior descending aorta, lower part of the trachea, main bronchi, lower part of the esophagus, vena cava (superior and lower), thoracic duct, vagus, sympathetic, phrenic nerve; anterior - mainly the thymus gland.
Severe, even fatal signs of compression can be caused in the mediastinum (as well as in the brain) by any tumor (in the broad sense of the word), not only malignant, but even benign and inflammatory.
The most common complaints with compression of the mediastinal organs are shortness of breath, cough with sputum, change in voice, pain, dysphagia; Objective signs include impaired local circulation with edema, roundabout circulation, local cyanosis, etc.
Shortness of breath is most often caused by compression of the trachea or bronchi, stagnation of blood in the lungs, including due to compression of the pulmonary veins at the point where they flow into the heart, compression of the recurrent nerve, etc.
It should be imagined that in the origin of shortness of breath in diseases of the mediastinum, the neuroreflex effect on the part of the respiratory tract receptors, as well as vascular baroreceptors, etc., is of primary importance.
Congestive cough, the formation of roundabout venous circulation and other mediastinal compression signs are of the same origin. Representing the manifestation of adaptive mechanisms for the restoration of various aspects of impaired organ activity, shortness of breath, cough, etc., at the same time, often achieve excessive Strength; in these cases, it is advisable to strive to alleviate them.

Shortness of breath develops in several periods - first only after physical stress or in case of excitement, then it becomes
constant, is inspiratory or also expiratory in nature, often accompanied by stridor (with compression of the trachea); as the disease progresses, orthopnea takes on the character, the patient cannot lie down, shortness of breath greatly disrupts sleep; It is not so rare that death occurs from strangulation.

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The cough is often paroxysmal, convulsive or whooping cough-like in nature when irritated by enlarged lymph nodes or when the process spreads to the mucous membrane of the tracheal bifurcation. Cough can also be a consequence of congestive or inflammatory bronchitis, irritation of the vagus nerve. The cough, like the voice, may be hoarse, weak or silent, with a special hue from swelling or paralysis vocal cords(with compression of the recurrent nerve). The cough is initially dry or with sputum, mucous from excessive secretion and retention of mucus or mucopurulent, sometimes, with the development of bronchiectasis from compression of the bronchus, very copious. Often the sputum is stained with blood (congestion, bronchiectasis, rupture of blood vessels).
Particularly painful are pains that occur either in the form of attacks radiating to the neck or arm due to pressure on the brachial plexus or in the form of a feeling of numbness or pressure in one arm.
Difficulty swallowing (dysphagia) rarely reaches the degree that is observed with diseases of the esophagus itself.
When the superior vena cava or its main branches are compressed, swelling of the cervical tissue and shoulder girdle in the form of a cape and upper limbs, even swelling of the face, or one right or left hand. Blood from the superior vena cava system penetrates into the inferior
through the veins of the anterior wall of the body or mainly through the deeply embedded azygos and semi-gypsy veins (if they have escaped compression); with unilateral compression of the subclavian vein, collaterals lead from this side of the chest to the collectors of the superior vena cava of the opposite side; Due to swelling of the veins of the orbit and swelling of the tissue, bulging eyes may develop. Small skin veins on the face and chest are dilated. Superficially located veins have the appearance of blue-purple, “leech” cords. Venous stagnation is accompanied by extremely sharp local cyanosis due to stretching of the veins and slow blood outflow.
Disruption of blood flow through the arterial trunks is observed less frequently, mainly with an aortic aneurysm.
An objective examination also reveals other signs of compression of the mediastinal organs: uneven pupils or complete compression syndrome of the upper cervical sympathetic nerve with miosis, retraction of the eye, drooping eyelid, sweating and facial hyperemia on the affected side, persistently recurrent herpes zoster on the chest simultaneously with intercostal neuralgia due to compression of the roots, high standing of the diaphragm and other signs
unilateral paralysis of the phrenic nerve, effusion into the pleural cavity as a result of accumulation of the contents of the milk vessels - chylothorax with compression of the thoracic (lymphatic) duct. Compression of the bronchus produces the usual symptoms of bronchial obstruction up to massive atelectasis.
Other mediastinal signs are characteristic of mediastino-pericarditis: multicostal systolic retraction in the atrium, lack of forward movement of the lower part of the sternum during inspiration due to fusion with the spine, paradoxical pulse, systolic retraction of the laryngeal cartilage.
X-ray examination easily establishes congestion in the lungs, impaired patency of the esophagus (when contrast is given), high standing and paralysis of the diaphragm on the left or right side, displacement of the trachea (ascertained clinically), atrophy of the vertebral bodies, leading to transverse myelitis; examination with a laryngeal mirror - paralysis of the plus ligaments.
Signs of the disease itself that causes compression are easily detected, for example, enlarged lymph nodes in the neck or in the mediastinum (with lymphogranulomatosis, etc.), signs of mediastinal pleurisy, aortic aneurysm, mitral stenosis (causing compression of the lower laryngeal nerve in the case of a sharp increase in the left atrium), scarring tuberculous process with calcification, etc.

A mediastinal tumor is a neoplasm in the mediastinal space of the chest, which can vary in morphological structure. Benign neoplasms are often diagnosed, but approximately every third patient is diagnosed with oncology.

There are a large number of predisposing factors that determine the appearance of a particular formation, ranging from addiction to bad habits and dangerous working conditions, ending with the metastasis of a cancerous tumor from other organs.

The disease manifests itself in a large number of pronounced symptoms that are quite difficult to ignore. The most characteristic external signs include severe cough, shortness of breath, headaches and increased body temperature.

The basis of diagnostic measures is instrumental examinations of the patient, the most informative of which is considered to be a biopsy. In addition, a medical examination will be required and laboratory tests. Treatment of the disease, regardless of the nature of the tumor, is only surgical.

Etiology

Despite the fact that tumors and cysts of the mediastinum are a rather rare disease, its occurrence in most cases is caused by the spread oncological process from others internal organs. However, there are a number of predisposing factors, among which it is worth highlighting:

• long-term addiction to bad habits, in particular smoking. It is worth noting that the more experience a person has of smoking cigarettes, the greater the likelihood of acquiring such an insidious disease;
• decreased immune system;
• contact with toxins and heavy metals - this can include both working conditions and unfavorable conditions environment. For example, living near factories or industrial enterprises;
• constant exposure to ionizing radiation;
• prolonged nervous overstrain;
• poor nutrition.

This disease occurs equally in both sexes. The main risk group consists of people of working age – from twenty to forty years. In rare cases, malignant or benign neoplasms of the mediastinum can be diagnosed in a child.

The danger of the disease lies in the wide variety of tumors, which may differ in their morphological structure, damage to vital organs and the technical complexity of their surgical excision.

The mediastinum is usually divided into three floors:

• upper;
• average;
• lower.

In addition, there are three sections of the lower mediastinum:

• front;
• rear;
• average.

Depending on the part of the mediastinum, the classification of malignant or benign neoplasms will differ.

Classification

According to the etiological factor, mediastinal tumors and cysts are divided into:

• primary – originally formed in this area;
• secondary – characterized by the spread of metastases from malignant tumors that are located outside the mediastinum.

Since primary neoplasms are formed from various tissues, they will be divided into:

• neurogenic tumors of the mediastinum;
• mesenchymal;
• lymphoid;
• thymus tumors;
• dysembryogenetic;
• germ cell - develop from the primary germ cells of the embryo, from which sperm and eggs should normally be formed. It is these tumors and cysts that are found in children. There are two peaks of incidence - in the first year of life and in adolescence- from fifteen to nineteen years old.

There are several most common types of neoplasms, which will differ in their location. For example, tumors of the anterior mediastinum include:

• neoplasms of the thyroid gland. They are often benign, but sometimes they are cancerous;
• thymoma and thymic cyst;
• mesenchymal tumors;

In the middle mediastinum, the most common formations are:

• bronchogenic cysts;
• lymphomas;
• pericardial cysts.

A tumor of the posterior mediastinum manifests itself:

• enterogenous cysts;
• neurogenic tumors.

In addition, clinicians usually distinguish between true cysts and pseudotumors.

Symptoms

For quite a long period of time, tumors and cysts of the mediastinum can occur without expressing any symptoms. The duration of this course is determined by several factors:

• place of formation and volume of neoplasms;
• their malignant or benign nature;
• the rate of tumor or cyst growth;
• relationship with other internal organs.

In most cases, asymptomatic mediastinal tumors are discovered completely by accident - during fluorography for another disease or for preventive purposes.

As for the period of expression of symptoms, regardless of the nature of the tumor, the first sign is pain in the chest area. Its appearance is caused by compression or germination of the formation into the nerve plexuses or endings. The pain is often moderate. The possibility of pain radiating to the area between the shoulder blades, shoulders and neck cannot be ruled out.

Against the background of the main manifestation, other symptoms of mediastinal neoplasms begin to appear. Among them:

• fatigue and malaise;
• increased body temperature;
• severe headaches;
• bluish lips;
• dyspnea;
• swelling of the face and neck;
• cough - sometimes with blood;
• uneven breathing, even attacks of suffocation;
• heart rate instability;
• profuse sweating, especially at night;
• causeless weight loss;
• increase in the volume of lymph nodes;
• hoarseness of voice;
• night snoring;
• increased blood pressure;
• slurred speech;
• disruption of the process of chewing and swallowing food.

In addition to the above symptoms, myasthenic syndrome very often appears, which is manifested by muscle weakness. For example, a person cannot turn his head, open his eyes, or raise his leg or arm.

Similar clinical manifestations are typical for mediastinal tumors in children and adults.

Diagnostics

Despite the variety and specificity of the symptoms of such a disease, it is quite difficult to establish a correct diagnosis based on them. For this reason, the attending physician prescribes a whole range of diagnostic examinations.

Primary diagnosis includes:

• a detailed interview with the patient will help determine the first time of onset and the degree of intensity of symptom expression;
• a clinician’s examination of the patient’s medical history and life history to determine the primary or secondary nature of the neoplasms;
• a thorough physical examination, which should include auscultation of the patient’s lungs and heart using a phonendoscope, examination of the condition of the skin, and measurement of temperature and blood pressure.

General laboratory diagnostic techniques do not have any particular diagnostic value; however, clinical and biochemical analysis blood. A blood test is also prescribed to determine tumor markers that will indicate the presence of a malignant neoplasm.

In order to determine the location and nature of the neoplasm according to the classification of the disease, it is necessary to carry out instrumental examinations, including:

Treatment

After confirming the diagnosis, a benign or malignant mediastinal tumor should be surgically removed.

Surgical treatment can be carried out in several ways:

• longitudinal sternotomy;
• anterolateral or lateral thoracotomy;
• transthoracic ultrasound aspiration;
• radical extended surgery;
• palliative removal.

In addition, if the tumor is malignant, treatment is supplemented with chemotherapy, which is aimed at:

• reduction of the volume of malignant formation - carried out before the main operation;
• final liquidation cancer cells, which may not have been completely removed during surgery;
• elimination of a tumor or cyst - in cases where surgical therapy cannot be performed;
• maintaining the condition and prolonging the patient’s life – when diagnosing a severe form of the disease.

Can be used as well as chemotherapy radiation treatment, which can also be the main or auxiliary technique.

There are several alternative methods fight against benign tumors. The first of them consists of a three-day fast, during which you need to refuse any food, and you are allowed to drink only purified water without gas. When choosing such treatment, you must consult with your doctor, since fasting has its own rules.

The therapeutic diet, which is part of complex therapy, includes:

• frequent and fractional food consumption;
• complete rejection of fatty and spicy foods, offal, canned food, smoked meats, pickles, sweets, meat and dairy products. It is these ingredients that can cause the degeneration of benign cells into cancerous ones;
• enriching the diet with legumes, dairy products, fresh fruits, vegetables, cereals, dietary first courses, nuts, dried fruits and herbs;
• cooking food only by boiling, steaming, stewing or baking, but without adding salt and fat;
• plenty of drinking regime;
• control over the temperature of food - it should not be too cold or too hot.

Besides this, there are several folk remedies that will help prevent the onset of cancer. The most effective of them include:

Potato flowers will help
prevent cancer

• potato flowers;
• hemlock;
• honey and mumiyo;
• golden mustache;
• apricot kernels;
• sagebrush;
• white mistletoe.

It is worth noting that starting such therapy on your own can only aggravate the course of the disease, which is why before using folk recipes You should consult your doctor.

Prevention

There are no specific preventive measures, which can prevent the appearance of a tumor in the anterior mediastinum or any other location. People need to follow a few general rules:

• give up alcohol and cigarettes forever;
• follow safety rules when working with toxins and poisons;
• If possible, avoid emotional and nervous stress;
• follow nutritional recommendations;
• strengthen immunity;
• undergo fluorographic examination annually for preventive purposes.

There is no unambiguous prognosis for such a pathology, since it depends on several factors - location, volume, stage of development, origin of the tumor, the age category of the patient and his condition, as well as the possibility of surgery.

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