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Pediatric Malignant Mediastinal Masses.

Rahat-Ul-Ain Kashif1, Mahwish Faizan1, Saadia Anwar1

  • 1Department of Pediatric Hematology-Oncology and Bone Marrow Transplant, The Children's Hospital and Institute of Child Health, Lahore, Pakistan.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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Summary
This summary is machine-generated.

Pediatric malignant mediastinal masses present with fever and respiratory distress. Low literacy and delayed diagnosis significantly worsen outcomes in resource-limited settings.

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Area of Science:

  • Pediatric Oncology
  • Thoracic Oncology
  • Epidemiology

Background:

  • Mediastinal masses in children are rare but can be life-threatening.
  • Understanding their clinical spectrum in resource-limited settings is crucial for improving outcomes.
  • Limited data exists on the specific challenges and characteristics of these tumors in under-resourced environments.

Purpose of the Study:

  • To delineate the clinical presentation, diagnostic challenges, and treatment outcomes of pediatric malignant mediastinal masses.
  • To identify factors associated with poor prognosis in a resource-limited healthcare setting.
  • To provide insights for improving the management of these rare pediatric cancers.

Main Methods:

  • A descriptive study was conducted at a tertiary care hospital in a resource-limited setting.
  • Data was collected from children diagnosed with malignant mediastinal masses between October 2016 and November 2017.
  • Variables included demographics, clinical presentation, socio-economic factors, diagnostic methods, final diagnoses, and patient outcomes.

Main Results:

  • The median age of diagnosis was 7.5 years, with a 2:1 male-to-female ratio. Common symptoms included fever, respiratory distress, and lymphadenopathy.
  • Delayed presentation was frequent (86%), often due to delayed diagnosis by healthcare professionals. T-cell acute lymphoblastic leukemia was the most common diagnosis.
  • Factors significantly associated with poor outcomes included primary diagnosis, delayed presentation, and family educational status. Forty-five percent of patients expired.

Conclusions:

  • The clinical spectrum and outcomes of pediatric malignant mediastinal masses in this setting differ from previously reported data.
  • Low literacy rates and delays in presentation are significant contributors to poor patient outcomes.
  • Targeted interventions to improve early diagnosis and access to care are essential.