Mediastinal Tumors

The mediastinum is the area between your lungs. It contains your heart, aorta, esophagus, thymus, lymph nodes, and trachea. A mediastinal tumor is a growth—either cancerous or benign—located in this spot. Mount Sinai's highly trained thoracic surgeons can diagnose and treat these tumors. We use minimally invasive techniques whenever possible. Our team works closely with other specialists in the Mount Sinai Health System and the Icahn School of Medicine at Mount Sinai to give you the best possible care. We use a variety of diagnostic and treatment therapies.

Common Mediastinal Tumors

There are several types of mediastinal tumors. The ones we see most often are:

• Thymomas: Representing15-20 percent of all tumors, thymomas tend to grow slowly and expand into nearby organs. They may be associated with myasthenia gravis, a disease of the neuromuscular junctions. We remove these tumors surgically.
• Thymic carcinoma: This condition is rare and invasive. It is difficult to manage. We often treat it with chemotherapy or radiation.
• Lymphomas: Typicallyfound in the anterior or middle mediastinum. The most common are Hodgkin's disease and B-cell lymphoma. We usually diagnose lymphomas with a biopsy and treat with chemotherapy and radiation.

Symptoms of Mediastinal Tumors

Many people (about 60 percent) who have a mediastinal mass experience symptoms. These can include:

• Cough
• Pain below the breast bone
• Sense of fullness in the chest
• Shortness of breath
• Unanticipated weight loss

Diagnosis

We use a variety of approaches to diagnose mediastinal tumors.

• Computed tomography (CT) scan: Imaging the chest helps us determine the tumor location and size. We may perform a biopsy to see if it is benign or malignant.
• CT-guided biopsy: A needle biopsy is occasionally possible and sufficient to make a diagnosis.
• Mediastinoscopy: We make a small incision at the base of the neck. We look directly or with a small camera to observe any masses around the airway.

Surgical Removal of a Mediastinal Tumor

We can remove a mediastinal tumor in several ways. The most common are:

• Video-Assisted Thoracoscopic Surgery (VATS): We use a camera that projects images on a monitor to observe the chest cavity. This helps us remove the mediastinal or lung tumors. VATS lets us use smaller incisions and provides faster recovery than with open surgeries.
• Sternotomy / Hemi-Sternotomy: Used often with open heart operations. This procedure is particularly appropriate if the tumor is large or is invading vital structures such as a major vessel. Rarely, we may need to put you on cardiopulmonary bypass to perform this procedure safely.   

Follow-up Care for Mediastinal Tumors 

After surgery, you will follow up with our oncologists for the rest of your life. We will monitor you regularly. We want to catch any problem in its earliest stages. Our goal is to keep you healthy.