MEDIASTINAL TUMOURS

MediaStinal Tumours

• Definition: Mediastinal tumours are abnormal growths that occur in the mediastinum, which is the region in the chest cavity between the lungs.
• Classification:
  • Benign tumours:
    • Thymic cysts
    • Thymomas
    • Bronchogenic cysts
    • Enteric duplications
    • Dermoid cysts
  • Malignant tumours:
    • Thymic carcinomas
    • Thymic lymphomas
    • Small cell lung cancer
    • Non-small cell lung cancer
    • Lymphoma
  • Germ cell tumours:
    • Teratomas
    • Yolk sac tumours
    • Choriocarcinoma
    • Embryonal carcinoma
• Types:
  • Thymic tumours:
    • Thymomas are the most common type of thymic tumour, accounting for about 50% of all mediastinal tumours.
    • Thymic carcinomas are malignant tumours that arise in the thymus gland.
  • Lymphomas:
    • Hodgkin lymphoma
    • Non-Hodgkin lymphoma
  • Germ cell tumours:
    • Teratomas are the most common type of germ cell tumour, accounting for about 60% of all germ cell tumours.
    • Yolk sac tumours are malignant tumours that arise in the yolk sac.
    • Choriocarcinoma is a rare type of germ cell tumour that arises in the placenta.
    • Embryonal carcinoma is a malignant tumour that arises in the embryonic tissue.
• Causes:
  • Unknown
  • Genetic predisposition
  • Environmental factors
  • Radiation exposure
• Clinical features:
  • Coughing
  • Chest pain
  • Shortness of breath
  • Fatigue
  • Weight loss
  • Fever
  • Night sweats
• Investigations:
  • Chest X-ray
  • CT scan
  • MRI
  • PET scan
  • Biopsy
• Complications:
  • Respiratory failure
  • Cardiac tamponade
  • Superior vena cava syndrome
  • Paraneoplastic syndromes
• Management:
  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Immunotherapy
• Treatment:
  • Surgery:
    • Surgical resection is the primary treatment for thymomas and other benign tumours.
    • Surgical resection may also be indicated for malignant tumours, depending on the stage and extent of the disease.
  • Chemotherapy:
    • Chemotherapy is the primary treatment for malignant tumours, such as lymphomas and germ cell tumours.
    • Chemotherapy may also be used as adjuvant therapy after surgery.

Homoeopathic Therapeutic Medicines:

• Arsenicum album: For symptoms such as coughing, chest pain, and shortness of breath.
• Belladonna: For symptoms such as fever, headache, and fatigue.
• Pulsatilla: For symptoms such as mood swings, irritability, and emotional instability.
• Sulfur: For symptoms such as skin lesions, hair loss, and nail changes.

Blood Supply:

• The mediastinum receives blood supply from the following arteries:
  • Internal thoracic artery
  • Superior intercostal artery
  • Inferior phrenic artery
  • Bronchial arteries
• The blood supply to the thymus gland comes from the inferior thyroid artery and the internal thoracic artery.

Nerve Supply:

• The mediastinum receives nerve supply from the following nerves:
  • Phrenic nerve
  • Vagus nerve
  • Sympathetic nerves
  • Parasympathetic nerves
• The nerve supply to the thymus gland comes from the vagus nerve and the sympathetic nerves.

Clinical Anatomy:

• The mediastinum is a narrow, elongated space between the lungs that contains the heart, major blood vessels, and other vital structures.
• The thymus gland is a lymphoid organ located in the anterior mediastinum that plays a key role in the development and maturation of immune cells.
• The mediastinum is bounded by the following structures:
  • Pleura (superior and inferior surfaces)
  • Pericardium (anterior surface)
  • Diaphragm (inferior surface)
  • Sternum (anterior surface)
  • Ribs (lateral surfaces)