Mediastinal Tumor: Symptoms and Treatment
The tumor of the mediastinum is a neoplasm in the mediastinal space of the chest, which can be different in morphological structure. Often benign neoplasms are diagnosed, but about one in three patients have oncology.
There are a large number of predisposing factors causing the emergence of a particular education, from addiction to bad habits and dangerous working conditions, ending with metastasis of a cancerous tumor from other organs.
The disease manifests itself in a large number of pronounced symptoms, which are quite difficult to ignore. The most characteristic external symptoms include severe pain syndrome, cough, shortness of breath, headaches and fever.
The basis of diagnostic activities are instrumental examinations of the patient, the most informative of them is a biopsy. In addition, medical examination and laboratory tests are required. Therapy of a disease, regardless of the nature of the tumor, is only operational.
Despite the fact that tumors and cysts of the mediastinum are a rare disease, its occurrence in most cases is caused by the spread of the oncological process from other internal organs. However, there are a number of predisposing factors, among which is worth mentioning:
- long-standing addiction to bad habits, in particular to smoking. It is worth noting that the more a person has a longer history of smoking cigarettes, the greater the likelihood of acquiring such an insidious disease;
- reduction of the immune system
- contact with toxins and heavy metals — this can include both working conditions and unfavorable environmental conditions. For example, accommodation near plants or industrial plants
- permanent exposure to ionizing radiation
- prolonged nervous strain
- Poor nutrition.
A similar disease occurs equally in representatives of both sexes. The main risk group is people of working age — from twenty to forty years. In rare cases, malignant or benign neoplasms of the mediastinum can be diagnosed in the child.
The danger of the disease lies in a wide variety of tumors that can differ in their morphological structure, the damage to vital organs and the technical complexity of their surgical excision.
Mediation is divided into three floors:
In addition, there are three departments of the lower mediastinum:
Depending on the department of the mediastinum, the classification of malignant or benign neoplasms will differ.
According to the etiological factor, tumors and cysts of the mediastinum 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 different tissues, they will be divided into:
- neurogenic mediastinal tumors
- Thymus tumors
- germinogenous-cell — develop from the primary embryonic germ cells, from which spermatozoa and oocytes 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.
There are several most common types of tumors that will differ in the place of their localization. For example, tumors of the anterior mediastinum include:
- thyroid neoplasms. Often they are benign, but sometimes can be cancerous;
- thymoma and thymus cyst
- mesenchymal tumors
In the mediastinum most frequent formations are:
- bronchogenic cysts
- Pericardial cysts.
The tumor of the posterior mediastinum manifests itself:
- enterogenic cysts
- Neurogenic tumors.
In addition, it is customary for clinicians to isolate true cysts and pseudotumors.
Quite a long period of time, tumors and cysts of the mediastinum can occur without the expression of any symptoms. The duration of such a flow is determined by several factors:
- the place of education and the volumes of growths
- their malignant or benign nature;
- tumor growth rate or cyst
- relationship with other internal organs
In most cases, asymptomatic neoplasms of the mediastinum are detected quite by chance — during passage of fluorography relative to another disease or for preventive purposes.
As for the period of expression of symptoms, regardless of the nature of the tumor, the first symptom is the pain syndrome in the retrograde region. Its appearance is caused by the squeezing or germination of the formation into the nerve plexus or ending. Soreness is often of a temperamental nature. It is not excluded the possibility of irradiation of painful sensations in the area between the shoulder blades, in the shoulders and neck.
Against the background of the main manifestation, other symptoms of neoplasm of the mediastinum begin to attach. Among them:
- fast fatigue and malaise
- increase in body temperature;
- severe headaches;
- cyanosis of the lips
- shortness of breath;
- swelling of the face and neck
- cough — sometimes with blood impurities
- uneven breathing, right up to the attacks of suffocation
- instability of the heart rate;
- profuse sweating, especially at night
- causeless weight loss
- increase in lymph node volume
- night snoring;
- blood pressure increase
- indistinct speech
- Breaking the process of chewing and swallowing food.
In addition to the above symptoms, very often there is a myasthenic syndrome, which is manifested by muscle weakness. For example, a person can not turn his head, open his eyes, raise his leg or arm.
Similar clinical manifestations are characteristic of mediastinal tumors in children and adults.
Despite the diversity and specificity of the symptoms of such a disease, it is quite difficult to establish a correct diagnosis on their basis. For this reason, the physician prescribes a whole range of diagnostic examinations.
Primary diagnostics includes:
- a detailed patient survey — will help determine the first time of occurrence and the degree of intensity of the expression of symptoms;
- the clinician’s examination of the medical history and a history of the patient’s life — to determine the primary or secondary nature of the neoplasm
- A thorough physical examination, which should include the auscultation of the lungs and the patient’s heart with a phonendoscope, examination of the skin condition, and measurement of temperature and blood pressure.
General laboratory diagnostic methods do not have a particular diagnostic value, however, a clinical and biochemical blood test is necessary. A blood test is also administered to determine cancer markers that will indicate the presence of malignant growth.
In order to determine the place of localization and the nature of the neoplasm according to the classification of the disease, it is necessary to perform instrumental surveys, among which:
- Radiography — for information about the size and area of tumor formation
- thoracoscopy — for examination of the pleura area
- mediastinoscopy — for assessing the state of the lymph nodes of the mediastinum, trachea, large vessels and the primary parts of the bronchi
- CT and MRI — to clarify the location of the tumor and cyst of the mediastinum, as well as to determine the relationship with nearby organs
- A biopsy is a method of obtaining the necessary material for subsequent morphological studies. Often, this procedure is performed during thoracoscopy or mediastinoscopy.
After confirming the diagnosis, a benign or malignant tumor of the mediastinum should be surgically removed.
Surgical treatment can be carried out in several ways:
- longitudinal sternotomy
- antero-lateral or lateral thoracotomy
- Transthoracic ultrasound aspiration
- Radical extended operation
- Palliative deletion
Besides this, with malignant neoplasm origin, treatment is supplemented by chemotherapy, which is aimed at:
- decrease in the volume of malignant formation — is performed before the main operation
- the final elimination of cancer cells that may not have been completely removed during surgery
- removal of the tumor or cysts — in cases where operable therapy is not possible
- maintaining the condition and prolonging the life of the patient — when diagnosing an illness in severe form
Along with chemotherapy, radiation treatment can be used, which can also be a basic or auxiliary technique.
There are several alternative methods to combat benign tumors. The first of these is a three-day fasting, during which you must give up any food, and only clean water without gas is allowed to drink. When choosing such a treatment, it is necessary to consult the attending physician, since fasting has its own rules.
The therapeutic diet, which is part of a comprehensive therapy, includes:
- frequent and fractional food consumption
- complete rejection of fatty and spicy dishes, offal, canned goods, smoked products, pickles, sweets, meat and dairy products. It is these ingredients that can cause benign cells to degenerate into cancerous cells
- enrichment of the diet with legumes, sour-milk products, fresh fruits, vegetables, cereals, dietary first dishes, nuts, dried fruits and herbs
- cooking only by cooking, steaming, quenching or baking, but without the addition of salt and fat
- copious drinking regime
- control over food temperature — it should not be too cold or too hot.
In addition, there are several folk remedies that can help prevent the emergence of oncology. The most effective of them are:
- potato flowers
- honey and mummies
- golden mustache
- apricot bones
- white mistletoe.
It should be noted that an independent beginning of such therapy can only exacerbate the course of the disease, why before applying folk recipes should consult a doctor.
There are no specific preventive measures that can prevent the appearance of a tumor of the anterior mediastinum or any other localization. People need to observe several general rules:
- Always give up alcohol and cigarettes;
- observe safety rules when dealing with toxins and poisons
- avoid emotional and nervous stress whenever possible
- follow recommendations on nutrition;
- Strengthen immunity;
- annually undergo a fluorographic examination for preventive purposes.
There is no single-valued prognosis for this pathology, because it depends on several factors — localization, volume, stage of development, the origin of the neoplasm, the age category of the patient and his condition, and the possibility of performing a surgical operation.