Neoplasm of the mediastinum. Errors in diagnosis and their solution

June 14, 2021
600
Resume

Mediastinal tumors are a rare pathology, the difficulty of detection of which is due to the lack of specific symptoms and the possibility of long-term asymptomatic course. The article presents the clinical picture, diagnosis, classification and approaches to treatment of epithelial tumors of the thymus. It is noted that surgical treatment plays an important role in the treatment and proper diagnosis of mediastinal tumors, especially malignant. The use of minimally invasive diagnostic methods (videothoracoscopy, transthoracic needle biopsy) allows to obtain morphological verification in preparation for treatment and to choose the safest and optimal type of treatment. The advantages of intra-arterial administration of chemotherapeutics are described. A clinical case of examination and treatment of a severe patient with posterior mediastinal tumor and concomitant pathology is given.

References:

  • 1. Grandhomme F. (1900) Über Tumoren des vorderen Mediastinums und ihre Beziehungen zu der Thymusdrüse. Heidelberg, Inaug. Diss.
  • 2. NCCN (2019) NCCN Guidelines. Version 1.2020. Thymomas and Thymic Carcinomas (https://www2.tri-kobe.org/nccn/guideline/lung/english/thymic.pdf).
  • 3. Ganul A.V. (2009) Optimization of diagnosis and treatment of patients with malignant mediastinal tumors. Oncology, 11(2): 131–135. (In Rus.).
  • 4. Masaoka A., Monden Y., Nakahara K., Tanioka T. (1981) Follow-up study of thymomas with special reference to their clinical stages. Cancer, 48(11): 2485–2492. doi: 10.1002/1097-0142(19811201)48:11<2485::aid-cncr2820481123>3.0.co;2-r.
  • 5. Masaoka A. (2001) Extended transsternal thymectomy for myasthenia gravis. Chest Surg. Clin. N. Am., 2: 369–387.
  • 6. Vetshev P.S., Zaratyants O.V., Zhivotov V.A. (2004) Thymus gland. In: A.P. Kalinin, N.A. Maistrenko, P.S. Vetshev. Surgical endocrinology: a guide. Peter, Saint Petersburg, 347–462 p. (In Rus.).
  • 7. Borisyuk B.O. (2009) Intra-arterial regional polychemotherapy in the complex treatment of malignant neoplasms of the mediastinum. Oncology, 11(2): 136–138. (In Rus.).