Spectrum of malignant mediastinal masses at a tertiary care centre in Central India

Background: Malignant mediastinal masses can develop from structures that are normally located or pass through the mediastinum during development, as well as from metastases of malignancies that arise elsewhere in the body. Since many tumors that occur in the mediastinum are undifferentiated and have overlapping histologic features, one must consider a broad differential diagnosis and perform a thorough evaluation. This is particularly important since appropriate therapy for various mediastinal tumors differs considerably and may significantly impact survival.Methods: Ours was a retrospective descriptive study of 48 patients who presented or referred to medical oncology department from January 2014 to December 2017 and in whom malignant cause of mediastenal mass was established. All details of the patients pertinent epidemiology, clinical history and pathological including immunohistochemistry details were studied.Results: Out of 48 patients,14 cases (29.2%) were in adolescent and young adult age group (15-29 years). Majority of the patients were symptomatic (91.6%) with most common being cough (87.5%) followed by chest pain (81.5%) and dyspnoea (79.1%). Four of the patients presented with superior vena-caval syndrome. Most of the tumors (64.6%) are in anterior mediastenum region. Histopathological examination revealed non-hodgkins lymphoma in 31.25%, Hodgkins lymphoma in 18.75%, leukaemia in 6.25%, germ cell tumor in 8.33%, thymic neoplasms in 4.16%, neurogenic tumors in 4.16%, lung carcinoma in 10.4% and metastatic carcinoma in 10.4%.Conclusions: Malignant mediastinal masses have a broad range of diagnosis, establishing of which is important. While imaging help in narrowing the differential diagnosis, adequate pathological categorization should be done as many patients responds to specific line of therapy