Which of the following is NOT seen in Anterior Mediastinum?
Correct Answer: Neurogenic tumor
Description: (D) Neurogenic tumor[?]Primary tumors of the mediastinum: Thymoma, Neurogenic tumors, Germ cell tumors & Lymphoma.Neurogenic tumours:Derived from sympathetic nervous system or peripheral nerves & are more prevalent in the posterior mediastinum.These are painful, quite large & discovered accidentally on routine chest X-ray.Includes benign Neuroblastoma in childhood, & Schwannomas & Neurofibromas in adults.Phaeochromocytoma arises from the sympathetic chain & produces endocrine syndrome.Treatment is Excision of neurogenic tumours if symptomatic by using thoracotomy or VATS approach (of small tumours). MEDIASTINAL TUMORS AND OTHER MASSESSuperior MediastinumAnterior MediastinumPosterior MediastinumMiddle MediastinumLymphomaThymomaNeurogenic tumorsBronchogenic cystThymomaTeratomaLymphomaPericardial cystThyroid lesionsLymphomaGastroenteric herniaLymphomaMetastatic carcinomaThyroid lesions Parathyroid tumorsParathyroid tumors Other Primary Tumours of Mediastinum[?]Thyroid Tumour:Ectopic thyroid tissue (retrosternal goiter) & parathyroid seen in the anterior mediastinum.Excision of retrosternal thyroids (if there is local airway compression & strider) done by trans-cervical incision, are median sternotomy.[?]Thymoma:Most common mediastinal tumour (25%) & derived from thymus gland.Behave from benign to aggressively invasive (Masaoka classification system used to stage thymomas).Associated with Myaesthenia Gravis (MG), & respond to excision of the thymus gland.Malignancy of thymoma is indicated by capsular invasion.Treated by Complete Thymectomy, through median sternotomy.[?]Lymphoma:Lymphomas seen in anterior mediastinum, and can cause superior vena cava obstruction or local compression.Treatment is by chemotherapy, & surgery.[?]Germ Cell Tumour:Most common site of extragonadal germ cell tumours is Anterior Mediastinum.Account for 13% of all mediastinal masses & cysts contain elements from all three cell types (mesoderm, endoderm & ectoderm).Seen in young adults & 75% are benign & cystic may cause compression locally, hence, dermoid cysts are best excised.In suspected malignancy, increased serum alpha-fetoprotein, hCG & carcinoembryonic antigen are detected.Initially treated with chemotherapy, if tumour marker normalisation & a persistent mass on CT requires surgical resection.If tumour markers fail to normalise, further chemotherapy is usually offered.Enlarged mediastinal lymphnodes are commonly seen by metastatic tumours.
Category:
Surgery
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