Presentation
Herein we present a case where an attempt to downsize the tumor to a resectable state with chemotherapy was employed. CASE PRESENTATION: A 32 year female presented with massive pericardial effusion and unresectable huge mediastinal mass. [ncbi.nlm.nih.gov]
Entire Body System
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Soft Tissue Mass
Chest CT imaging showed pulmonary edema, pleural effusions, and a middle mediastinum soft-tissue mass of 4.2 2.5cm. [ncbi.nlm.nih.gov]
Computed tomography (CT) image of the chest demonstrating well-demarcated soft tissue mass in superoanterior mediastinal mass (arrow). Figure 3. [thoracic.org]
Lymphoma Lymphoma presents as a soft tissue mass with widening of mediastinum, which is often revealed on conventional radiographs. An anterior or middle mediastinal location is more common than posterior. [jaocr.org]
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Intermittent Fever
A 3-month-old boy presented with history of low grade intermittent fever, cough and noisy breathing for 2 weeks. A chest X-ray showed massive mediastinal widening. Biopsy of the mass confirmed LCH. [ncbi.nlm.nih.gov]
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Amyloidosis
Abstract AL amyloidosis presenting as a solitary mediastinal mass is a rare occurrence, with only a few cases reported in the literature. [ncbi.nlm.nih.gov]
Respiratoric
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Cough
A 3-month-old boy presented with history of low grade intermittent fever, cough and noisy breathing for 2 weeks. A chest X-ray showed massive mediastinal widening. Biopsy of the mass confirmed LCH. [ncbi.nlm.nih.gov]
CC: 3 weeks of chest pain and dry cough ID: 56 yo female with migraines and uterine cyst presents with sharp, non-exertional chest pain and dry cough for the past 3 weeks. She was found to have a mediastinal mass on CXR and 6% peripheral blasts. [uscmedicine.blog]
A 32-year-old man with a 20-year history of smoking presented with a 1-month history of nonproductive cough at night, dyspnea, left thoracic pain, and an involuntary weight loss of 7 kg (15 lb). [nejm.org]
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Hoarseness
A mediastinal mass may also result in a compression of the superior vena cava (superior vena cava syndrome), Horner’s syndrome, or hoarseness (due to compression of left laryngeal nerve). [learn.pediatrics.ubc.ca]
Signs & Symptoms Hemoptysis, recurrent pulmonary infection (airway compression) Dysphagia (esophageal compression) Paralysis (spinal column involvement) Elevated hemidiaphragm (phrenic nerve damage) Hoarseness (recurrent laryngeal involvement) Horner’ [slideshare.net]
Other symptoms may include: Persistent cough Shortness of breath or wheezing Fever or night sweats Difficulty swallowing or hoarseness Unexplained weight loss In addition to an X-ray or CAT scan, masses are diagnosed using a scope to look inside the chest [swedish.org]
Symptoms begin when the mass begins pressing on the surrounding areas, causing discomfort and a combination of the following: Chills and fever Cough (and/or coughing up blood) Shortness of breath Pain in the chest Hoarseness of the voice Wheezing Swollen [loyolamedicine.org]
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Mediastinal Disease
Mediastinal diseases are conditions that arise from tissues in this cavity. [utswmedicine.org]
Lymphadenopathy mediastinal - disease in the lymph nodes. Pericardial cysts which include growths that start in the lining of the heart. Tracheal tumors. Posterior mediastinal tumors include: Lymphadenopathy mediastinal - disease of the lymph nodes. [cedars-sinai.edu]
Imaging plays an essential role in the diagnosis, staging and follow-up of mediastinal disease. [link.springer.com]
The chest CT is the most widely used imaging examination for mediastinal disease. For thymic cysts, the chest CT can describe the shape, contour, CT value, relationship to adjacent tissue, and the contrast-enhanced CT appearance. [ctisus.com]
Gastrointestinal
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Dysphagia
Respiratory symptoms and dysphagia can occur due to bronchial and esophageal obstruction respectively. [learn.pediatrics.ubc.ca]
In children, there is history of cough, dyspnoea, dysphagia and frequent chest infections whereas adults present with chest pain or dysphagia. [ijaweb.org]
Signs & Symptoms Hemoptysis, recurrent pulmonary infection (airway compression) Dysphagia (esophageal compression) Paralysis (spinal column involvement) Elevated hemidiaphragm (phrenic nerve damage) Hoarseness (recurrent laryngeal involvement) Horner’ [slideshare.net]
Occasionally, mediastinal tumors cause nonspecific symptoms related to the compression/invasion of adjacent anatomical structures (chest pain, cough, dyspnea, dysphagia, superior vena cava syndrome, etc.). [scielo.br]
Lesions in the posterior mediastinum may encroach on the esophagus, causing dysphagia or odynophagia. [msdmanuals.com]
Skin
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Eczema
Hyperimmunoglobulin E syndrome is a rare multisystem inherited disorder characterised by high serum IgE levels, skin disorder causing eczema, dermatitis, recurrent staphylococcal infections and pulmonary infections and various skeletal and connective [ncbi.nlm.nih.gov]
Workup
Chest computed tomography and examination of serum markers provides the critical workup before a tissue diagnosis is obtained. Mediastinal NSGCT does not respond as well to chemotherapy, relapse more frequently and have the worst survival 3. [scielo.isciii.es]
The radiologic workup depends on the location of the mass ( Fig. 16-1 and Box 16-1 ). For masses localized within the anterior compartment of the mediastinum, computed tomography (CT) is a good diagnostic choice. [radiologykey.com]
Treatment
Treatment Treatment and Care for Mediastinal Masses Treatment for a mediastinal mass varies according to what kind of tumor it is (thymoma, lymphoma, neurogenic, etc.) and where it is located. [loyolamedicine.org]
Transthoracic echocardiography, computed tomography scan findings, and surgical treatment and pathologic examination are described. [ncbi.nlm.nih.gov]
Prognosis
CONCLUSION: Synovial sarcoma presenting with unresectable mediastinal mass carry a poor prognosis. [ncbi.nlm.nih.gov]
Cancer - Pictures, Symptoms, Signs, Survival Rate, Prognosis Amelanotic Melanoma - Pictures, Symptoms, Prognosis [cancerwall.com]
The WHO classification scheme correlates with the likelihood of invasiveness, a factor that has an important influence on treatment and prognosis. [radiologykey.com]
Therapy in stage I tumors consists of surgical resection with good prognosis. Stage II-III requires maximal resection possible followed by radiation. [en.wikipedia.org]
These tumors have a poor prognosis due, in part, to their bulk and relative chemosensitivity, but also due in part to their association with non-Germ cell elements and hematologic malignancies. [scielo.isciii.es]
Etiology
Gov't MeSH terms Aged Angiography/methods Echocardiography, Transesophageal Heart Septal Defects, Atrial/diagnosis* Heart Septal Defects, Atrial/physiopathology Humans Hypoxia/etiology* Lymphoma, Large B-Cell, Diffuse/diagnosis Lymphoma, Large B-Cell, [ncbi.nlm.nih.gov]
Additional diagnostic testing, usually imaging and biopsy, is indicated to determine etiology. CT with IV contrast is the most valuable imaging technique. [msdmanuals.com]
The major etiologies of anterior mediastinal masses are thymomas, lymphomas, germ cell tumors (particularly teratomas), thyroid masses, and aortic aneurysms. A useful CT criterion for narrowing the differential diagnosis is tumor density. [scielo.br]
Mediastinal masses in children are often symptomatic and can have a varied symptomatology and etiology. The most common symptoms at presentation are dyspnea, cough, fever, aching pain and general malaise. [learn.pediatrics.ubc.ca]
Prevention
Screening Prevention and Screening of Mediastinal Masses There is no method currently known to prevent developing a mediastinal mass. [loyolamedicine.org]
These cancerous tumors must be removed to prevent the spread of cancer. Cancerous tumors in the mediastinum could also start to compress organs in the chest, such as the heart, lungs, or esophagus. [openheartsurgery.com]
Considering the diagnosis of Graves disease for a child with an anterior mediastinal mass and without the typical physical findings of autoimmune hyperthyroidism (goiter, exophthalmos) may prevent unnecessary diagnostic studies and their associated financial [pediatrics.aappublications.org]
Placing the specimen in an endoscopic bag will prevent potential contamination and potential tumor spread. [sages.org]
Anesthetic management of these patients starts with a careful anesthetic plan including not only preventive measures but also prompt and effective intervention strategies should complications arise. [scielo.org.co]