Publication:

Retrospective analysis of mediastinal tumors in childhood

Background The aim of this study was to determine etiologic distribution, epidemiologic properties, treatment, clinical course and late effects of the treatment of the patients diagnosed with mediastinal tumor.

Methods Patients under 18 years old diagnosed with mediastinal tumors between January 1990 and June 2011 at the 19 Mayis university department of child oncology were examined retrospectively.

Results There were 50 (61%) males, 32 (39%) females with mediastinal tumor. Median age at diagnosis was 9.28 years (30 days-17.4 years). Most common symptoms were respiratory distress (29.2%) and cough (23.1%). Sixty eight cases (82.9%) were malignant. Two cases died before diagnosis. Thirty seven cases (45.1%) were located in anterior followed by 16 (19.5%) in middle and 23 (28%) in posterior mediastinum. Most common malignant tumors were lymphomas (n=46, 67.6%), followed by sarcomas (n=12, 17.6%), neural crest tumors (n=8, 11.8%) and germ cell tumors (n=2, 2.9%). Thirteen cases had vena cava superior syndrome and 4 cases had signs of spinal cord compression at the time of diagnosis. Forty eight cases (58.5%) were alive and symptom free on follow-up (mean 39.5 months, 3-139 months), and 22 (26.8%) were died. Sixteen cases (23.5%) had late effects. Overall survival for all malignant tumors were 60.5±7.8%.

Conclusions Mediastinal tumors should be considered in children with acute progressive respiratory distress and cough. Early diagnosis is still most important factor for prognosis.