How are tumors of the mediastinum diagnosed?

Updated: Feb 16, 2021
  • Author: Mary C Mancini, MD, PhD, MMM; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

Advances continue to be made in the areas of diagnostic imaging, biologic analysis, and therapy. For example, modalities such as positron emission tomoggraphy (PET) and radionuclide studies may be able to assist in the diagnosis of specific neoplasms and in posttherapy surveillance for recurrent disease. [1]

Angiographic techniques using localized intra-arterial injection of hypertonic contrast and embolization techniques have been used in several centers to obliterate mediastinal parathyroid adenomas. At present, this technology is used in patients who are considered a poor risk for surgery; however, with increased experience and skill, these methods may become useful in the treatment of many such lesions.

Numerous biologic markers have been identified for many tumors and will play a vital role in better identifying individual neoplasms so that treatment can be optimized.

Video-assisted thoracoscopic surgery (VATS) is part of the armamentarium of the thoracic surgeon for treatment of a number of mediastinal diseases. It is already used commonly for biopsy of masses and lymph nodes and has also been described for resection of various mediastinal cysts, mediastinal parathyroid adenomas, and localized benign tumors of the posterior mediastinum, such as ganglioneuromas. At several centers, VATS thymectomy has been performed. The completeness of thymic resection remains to be seen.


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