Primary Neoplasms of the Mediastinum

Heimburger, Irvin L.

doi:10.1001/archsurg.1963.01310120096015

Cited by 30 publications

(6 citation statements)

References 6 publications

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“…In a collected series of primary mediastinal tumors and cysts, 25%-49% of these lesions are malignant [1,2,[4][5][6][7][8][9][10][11][12][13]. Pediatric primary mediastinal tumors are even less common, but the risk of malignancy is increased to approximately 75% [14,15].…”

Section: Commentmentioning

confidence: 99%

“…Primary tumors and cysts of the mediastinum in children and adults are uncommon; they represent only 1/1,076-3,400 admissions to tertiary care medical centers, and approximately 3% of tumors within the chest [1][2][3][4]. In a collected series of primary mediastinal tumors and cysts, 25%-49% of these lesions are malignant [1,2,[4][5][6][7][8][9][10][11][12][13]. Pediatric primary mediastinal tumors are even less common, but the risk of malignancy is increased to approximately 75% [14,15].…”

Section: Commentmentioning

confidence: 99%

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Primary Mediastinal Malignancies in Children: Report of 22 Patients and Comparison to 197 Adults

et al. 2000

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Purpose. Examine a contemporary series of patients with primary pediatric malignant mediastinal tumors and determine epidemiology, histology, treatment, and survival.Patients and Methods. All malignancies diagnosed between January 1, 1973 and December 31, 1995 were analyzed.Results. Twenty-two patients, age 18 years or less, with pediatric primary mediastinal malignancies were identified from a database of 110,284 patients with primary malignancies. During the same period, 197 adult patients with primary mediastinal malignancies were identified. Fifty-nine percent of the pediatric patients were male. Median age was 11 years. Lymphoma was present in 55%, neurogenic malignancies in 23%, malignant germ cell tumors in 18%, and sarcoma in 5%. Neurogenic tumors presented in infants and lymphomas and germ cell tumors presented in teens (p = 0.005). In treated children, surgery was used more often in neurogenic tumors and germ cell tumors than in lymphomas (p = 0.002). Five-year survival was 74% for lymphomas, 67% for neurogenic tumors, 25% for germ cell tumors, and 61% overall (p = 0.23). Compared to adults, children had more neurogenic tumors (p < 0.001) and fewer thymomas (p = 0.0499). There were no significant differences in staging or survival between children and adults.Conclusions. Pediatric mediastinal malignancies occurred with a frequency of 1/5,013 patients with malignant tumors. Lymphoma, neurogenic tumors, and germ cell tumors predominated. Compared to adults, children had more neurogenic tumors and fewer thymomas. Within the pediatric group, differences were found in age of presentation between histologic groups. These differences between adults and children, and between infants and teens, should be considered when evaluating a patient suspected of having mediastinal malignancy.

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Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Primary Mediastinal Malignancies in Children: Report of 22 Patients and Comparison to 197 Adults

et al. 2000

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“…However, we would agree with Heimburger et al (1963) that special diagnostic procedures are helpful in detecting aneurysms, diaphragmatic hernia, and primary tumours of the lung, but no study can give specific diagnosis in the majority of primary mediastinal tumours. Thoracotomy, with either biopsy or surgical removal, has proved the only reliable method of diagnosis.…”

Section: Discussionmentioning

confidence: 54%

“…The clinical symptoms of a mediastinal tumour are chest pain, dyspnoea, cough, shortness of breath, dysphagia, pneumonia, hoarseness, and upper respiratory tract infections (Heimburger, Battersby, and Vellios, 1963;Oldham, 1971). All of these are not specific for the presence of a mediastinal tumour.…”

Section: Discussionmentioning

confidence: 99%

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Carcinoid tumour of the thymus gland: report of a case.

Hughes¹,

Ancalmo²,

Leonard³

et al. 1975

Thorax

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Malignant schwannomas of the mediastinum.Report of two cases and review of the literature

Ingels

Campbell

Giampetro

et al. 1971

Cancer

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Two cases of malignant schwannoma of the mediastinum are presented, and the literature is reviewed. T h e terminology applied to the benign, and especially the malignant, nerve sheath tumors is varied. Cases collected from the literature suggest that nerve sheath tumors are the most common type of neoplasm of the mediastinum and are usually located posteriorly. T h e most frequent type is the neurofibroma, followed by the ganglioneuroma and the schwannoma. The ratio of benign to malignant schwannomas is 10.8 to 1. Malignant schwannomas have a body-wide distribution, occur with equal frequency in both sexes and can occur at any age, the mean being approximately 44 years of age in both males and females. Seventy-two per cent of the malignant cases were fatal, with a n average survivaI time of approximately 2 years. In both of the cases presented, the tumor extended into the pericardial space and produced a serosanguineous effusion and partial cardiac tamponade. Neither tumor could be completely resected and despite postoperative irradiation and chemotherapy, neither patient survived 2 years. UMORS OF NEURAL ORIGIN ARE THE MOSTT common primary neoplasm of the mediastinum and are usually found posteriorly.Today the are broadly classified into 2 groups: those arising from nerve sheaths, which include the neurofibroma, the schwannoma or neurilemoma, and their malignant counterpart; and those derived from nerve cells of the sympathetic nervous system, which include the ganglioneuroma, the ganglioneuroblastoma, and the neuroblastoma.Classification of neural tumors began in the mid-nineteenth century when Virchow divided those neoplasms which appeared to be associated with nerves into "true" and "false neuromas." During the next hundred years many others have added their own system of classification and terminology to the literature, usually based on their concept CASF REPORT^ Case 1. B.K., a 48-year-old Caucasian man, was admitted with acute shortness of breath, fullness and tightness in his chest, and right upper abdominal discomfort which had progressed over a 2-day period. Admission temperature was 99.2'. pulse 88 per minute, and blood pressure 112/90 on inspiration, with 98 mmHg sjstolic on expiration, a 14-mm paradoxicus. Positive phj sical findings included maiked distention oE neck veins which increased with inspiration, rales at both lung hases, posteriorly, antl dullness to percussion over the right chest, posteriorly, to approximately T-9. Cardiac examination revealed dullness to percussion, laterally to the anterior axillary line on the left and to the midclavicular line on the right, and superiorly, to the second intercostal space approximately 2 cm lateral to the left sternal border. There was a regular rhythm, but the heart tones were muffled and a Grade I-II/VI systolic murmur was heard along the left sternal border without radiation. T h e liver was tender and palpable 6 cm below the right costal margin in the midclavicular line and a positive hepatojugular reflux was demonstrated.Lrtbointo~y: T h e BUN w...

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Primary Neoplasms of the Mediastinum

Cited by 30 publications

References 6 publications

Primary Mediastinal Malignancies in Children: Report of 22 Patients and Comparison to 197 Adults

Primary Mediastinal Malignancies in Children: Report of 22 Patients and Comparison to 197 Adults

Carcinoid tumour of the thymus gland: report of a case.

Malignant schwannomas of the mediastinum.Report of two cases and review of the literature

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