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Primary mediastinal tumors in children
H Sairanen1, M Leijala, I Louhimo
1Children's Hospital, University of Helsinki, Finland.
Insights
Mediastinal tumors in children are often malignant and can cause severe respiratory issues, especially in infants. Surgical intervention, except for lymphomas, offers good outcomes for these pediatric patients.
Area of Science:
- Pediatric Oncology
- Thoracic Surgery
Background:
- Primary mediastinal tumors are rare in children.
- These tumors can present with life-threatening respiratory compromise, particularly in young children.
Purpose of the Study:
- To analyze the clinical characteristics, diagnostic methods, and treatment outcomes of primary mediastinal tumors in pediatric patients.
- To evaluate the efficacy of surgical and non-surgical management strategies.
Main Methods:
- Retrospective review of 159 pediatric patients treated for primary mediastinal tumors between 1950 and 1986.
- Diagnosis based on chest X-ray and surgical findings; biopsy used for lymphoma diagnosis.
- Treatment included surgery (excision) and non-surgical protocols (lymphoma).
Main Results:
- Of 159 tumors, 77 were malignant and 82 benign. No mortality in benign tumor cases.
- Tracheal compression occurred in 45.3% of children under 2 years.
- Survival rate for malignant tumors was 62.3% at a mean follow-up of 6.0 years.
- Complete or partial excision achieved in 59.0% of non-lymphatic malignant tumors.
Conclusions:
- Mediastinal tumors in children require prompt diagnosis and treatment due to potential for severe respiratory distress.
- Surgery is the primary treatment for non-lymphatic malignant mediastinal tumors, yielding favorable outcomes.
- Even malignant mediastinal tumors in children can have good prognoses with appropriate management.
Abstract:
From 1950-1986, a total of 159 children (age 1 day-16 years) were treated for primary mediastinal tumors at our hospital. There were 77 malignant and 82 benign tumors. Tracheal compression causing respiratory distress was a significant symptom in 45.3% (24/53) of the children under 2 years of age. The diagnosis was based on the chest X-ray and the findings at surgery. Malignant lymphoma was usually diagnosed by cervical lymph node biopsy (23/39) but the treatment protocol was non-surgical. Non-lymphatic malignant tumors were completely or partially excised in 59.0% (23/39) of the cases. There was no early or late mortality in patients with benign tumors. At follow-up (0.5-24 years; mean 6.0 years), 62.3% (48/77) of the patients with malignant tumors were alive and symptom free. About half of the mediastinal tumors in children are malignant. Mediastinal tumors in small children can cause severe respiratory symptoms demanding urgent treatment. The treatment of choice is surgery (except in lymphomas) and the results are good even in malignant tumors.
