is a group of malignant tumors that originate from organs and tissues located in this area. The mediastinum is bounded laterally by the lungs, anteriorly and posteriorly by the sternum, spinal column and ribs, and below - the diaphragm. Here are the large blood vessels and lymphatic vessels Therefore, mediastinal cancer often occurs secondary to metastasis from other parts of the body. The organs of the mediastinum themselves also serve as a source of neoplasm - it is caused by proliferation of cells of the thymus, trachea, esophagus, bronchi, nerve trunks, pericardium, adipose or connective tissue. There are also atypia, the cytology of which resembles embryonic tissue.

The urgency of the problem is that middle age sick people are 20-40 years old. It occurs in adolescents (girls and boys), and even in children. Elderly people also suffer from this disease. The incidence in Russia is 0.8-1.2%, or a fifth of all tumors in this area. Epidemiology shows that it occurs in both men and women throughout the world, although there are epidemiologically unfavorable areas. For example, female thyrotoxic goiter is common in mountainous regions, where the incidence of cancer in the anterior part of the mediastinum is high.

It is possible to find out how dangerous education is only by histological examination, making differentiation difficult. Even a benign nature does not exclude malignancy. Mediastinal cancer is deadly, the prognosis is unfavorable, the mortality rate is high, and not only because of the difficulties of diagnosis, but also because it is often inoperable due to involvement large vessels, nerves, vital organs. However, this does not mean that it is incurable - there is a chance to survive, you need to continue to fight.

Types of mediastinal cancer

Classification of mediastinal cancer is difficult, since there are descriptions of more than 100 types of neoplasms, including primary and secondary types.

Based on the cytological picture, the following types are distinguished::

• . small cell - rapidly progresses, as it metastasizes hematogenously and lymphogenously;
• . squamous - develops over a long period of time, arises from mucous membranes (pleura, pericardium, vascular walls);
• . embryonic, or germiogenic - formed from embryonic membranes due to pathologies of fetal embryogenesis;
• . low differentiated.

Forms are distinguished by origin and localization:

• . angiosarcoma;
• . liposarcoma;
• . synovial sarcoma;
• . fibrosarcoma;
• . leiomyosarcoma;
• . rhabdomyosarcoma;
• . malignant mesenchymoma.

International TNM classification used to determine the prevalence of the disease.

Mediastinal cancer, symptoms and signs with photos

The very beginning of mediastinal cancer is asymptomatic, which is expressed by the absence of complaints from the patient until the size of the tumor increases. You should pay attention to weakness, fatigue, weight loss, which is up to 10-12 kilograms in 1-2 months.

With primary involvement of the bronchi and trachea, the disease is expressed by breathing problems (shortness of breath, cough). In the early stages of pericardial damage, the first obvious manifestations are arrhythmia, bradycardia, and rapid pulse. The pain syndrome is pronounced, it hurts behind the sternum, pain and burning are localized on the developmental side and radiate to the back to the scapula.

External, visible changes in the body occur if the central veins are compressed. When pressure is applied to the superior vena cava, cyanosis is observed; it also appears when the tumor compresses the lungs and tracheobronchial tree. Red spots on the skin, face, dermographism, increased sweating, drooping of the eyelid, dilation of the pupil, retraction of the eyeball - characteristic one-sided symptoms of germination of the sympathetic trunk.

Initial signs of recurrent germination laryngeal nerve- hoarseness of voice, change in timbre; spinal cord- paresthesia (pins and needles sensation). Oncological alertness should also arise when isolated pleurisy or pericarditis is detected.

TO late symptoms include: temperature without visible inflammation and infectious process, cachexia, exhaustion. Bone pain indicates metastases.

The warning signs of mediastinal cancer are so varied that not every doctor can suspect its development. In this case, you cannot simply palpate the lump or see the ulcer, so the main methods of diagnosis remain instrumental methods examinations.

Causes of mediastinal cancer

The causes of mediastinal cancer are varied; it is difficult to determine what triggers the oncological process. Psychosomatics, one of the branches of medicine, believes that oncology is formed due to changes in a person’s psycho-emotional state.

Genetics blames heredity, when the gene that provokes the formation of atypia is inherited. A predisposition may arise during embryo formation due to impaired fetal embryogenesis.

There is also a viral theory, according to which a pathogen (for example, papilloma virus, AIDS or herpes) causes the appearance of gene mutations. However, mediastinal cancer is not contagious to others; it is impossible to become infected by airborne droplets or other means.

Doctors identify factors that cause cancer degeneration, the main of which are:

• . age—the body’s immunological defense gradually decreases;
• . carcinogens from food or pollution environment;
• . radiation and exposure;
• . pregnancy pathologies;
• . chronic diseases.

Stage characterizes the extent of spread of mediastinal cancer:

• . zero, or in situ (0) - at an early stage the pathology is practically not detected;
• . the first (1) is an encapsulated tumor without invasion into the mediastinal tissue;
• . second (2) - there is infiltration of fatty tissue;
• . third (3) - germination of several mediastinal organs and lymph nodes;
• . fourth and last (4) - there are distant organs affected by metastases.

Photos and images of computer and magnetic resonance imaging, which are attached to the diagnostician’s report, will help determine the degree.

If there is a suspicion of mediastinal cancer, to check it, identify a tumor and make a diagnosis, use:

• . survey, acquaintance with the medical history;
• . examination (finger percussion, palpation);
• . tumor marker test;
• . Ultrasound - reveals other lesions;
• . X-ray examination and fluorography (the main method of diagnosis);
• . endoscopic examinations(bronchoscopy, esophagoscopy, thoracoscopy);
• . PET-CT scan to determine distant metastasis;
• . computer or magnetic resonance imaging to obtain layer-by-layer photographs of tumor formation.

Treatment of mediastinal cancer

Mediastinal cancer is curable if patients consult a specialist in time. An effective remedy against, which will help you defeat and get rid of cancer, suggests thoracic surgery. The surgeon’s actions are aimed at complete removal involved structures under general anesthesia. Operable mediastinal cancer and all affected tissue are removed by thoracotomy, after which radiation and chemotherapy are prescribed. The goal is to stop the growth of the tumor and slow down the spread. Radiation and chemotherapy are also used if there are contraindications to surgical intervention. Symptomatic therapy can help alleviate the condition at all stages - the patient takes strong painkillers and cardiovascular medications.

Sometimes clinical remission does not last long. When the disease occurs again (relapses), the patient's life expectancy is reduced and treatment tactics change. If mediastinal cancer is not treated, its consequences are death. Advanced mediastinal cancer and decay cancerous tumor also affect the time allotted to the patient. The survival rate is 35%, it is influenced by the speed, time and dynamics of the process. Recovery is possible with timely detection of the tumor, which often happens when contacting medical institution for other diseases with similar symptoms, or during preventive examinations.

Prevention of mediastinal cancer

Since the etiology of mediastinal cancer varies and it is not possible to completely exclude the damaging factor, in order to prevent it, it is recommended to general recommendations that reduce the chance of getting sick and to some extent protect against cancer:

• . active image life;
• . absence of bad habits (smoking, alcohol);
• . normal sleep;
• . daily routine;
• . healthy eating.

Avoid stress, overwork, strong physical activity, pass on time preventive examinations and fluorography, which can show formation. Only provided on time medical care will help avoid death.

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There are several approaches to dividing our body into sections. Clear boundaries of organs and systems, as well as their totality, help doctors more accurately navigate the body, prescribing treatment, describing any malfunctions and pathologies. At the same time, doctors, regardless of their profile, use the same terms to refer to specific areas of the body. So the zone that is localized in the middle and in the upper part of the body can be called the sternum. However, experts medical profile it is called the mediastinum. Today we will talk about the mediastinum, mediastinal tumors, mediastinal nodes, what is its anatomy, where is it located.

Structure

To more accurately describe the location of pathologies and plan correction methods, the mediastinum is divided into upper and lower, as well as anterior, posterior and middle.

The anterior part of this area is limited on the front side by the sternum, and on the back by the brachiocephalic vessels, as well as the pericardium and brachiocephalic trunk. The thoracic veins pass inside this space; in addition, the thymus is located in it, in other words thymus. It is in front of the mediastinum that it goes thoracic artery And lymph nodes. The middle part of the area under consideration includes the heart, hollow, brachiocephalic, phrenic, and pulmonary veins. In addition, it includes the brachiocephalic trunk, aortic arch, trachea, main bronchi, pulmonary arteries. As for the posterior mediastinum, it is limited by the trachea, as well as the pericardium from the frontal area, and the spine from the posterior side. This part includes the esophagus and the descending aorta, in addition it includes the hemizygos and azygos vein, and the thoracic lymphatic duct. The posterior mediastinum also contains lymph nodes.

The upper zone of the mediastinum consists of all anatomical structures, located above the upper border of the pericardium, represented by the upper aperture of the sternum, as well as a line extending from the angle of the chest and intervertebral disc Th4-Th5.

As for the lower mediastinum, it is limited top edges diaphragm and pericardium.

Mediastinal tumors

Various tumor-like formations can develop in the mediastinum area. At the same time, neoplasms of this organ include not only true formations, but also those cysts and tumor-like ailments that have a different etiology, location, and other course of the disease. Any neoplasm of this type originates from tissues of different origins, they are united solely by their location. In this case, doctors consider:

Neoplasm Clinic

Tumor formations are usually found in young and middle-aged people. age group, regardless of gender. As practice shows, mediastinal diseases often do not indicate themselves; they can only be detected during preventive studies. At the same time, there are some symptoms that can indicate such disorders and which need to be paid attention to.

So, tumor formations inside the mediastinum often make themselves felt by mild painful sensations that can radiate towards the neck, shoulder area and between the shoulder blades. If the formation grows inside the borderline sympathetic trunk, the patient’s pupils dilate, drooping of the eyelid and retraction of the eyeball may be observed.

Damage to the recurrent laryngeal nerve often makes itself felt by hoarseness in the voice. The classic symptoms of tumor formations are painful sensations in the chest area, as well as a feeling of heaviness in the head. In addition, shortness of breath may occur, cyanosis, swelling of the face, and disturbances in the passage of food through the esophagus may occur.

If tumor diseases reach an advanced stage of development, the patient experiences a noticeable increase in body temperature, as well as severe weakness. In addition, arthralgia, irregular heart rhythms, and some swelling of the extremities are observed.

Lymph nodes of the mediastinum

As mentioned above, there are many lymph nodes inside the mediastinum. The most common lesion of these organs is lymphadenopathy, which can develop against the background of metastases of carcinoma, lymphoma, as well as some non-tumor diseases, for example, sarcoidosis, tuberculosis, etc.

In addition to changes in the size of the lymph nodes, lymphadenopathy makes itself felt by fever, as well as excessive sweating. In addition, severe weight loss occurs, hepatomegaly and splenomegaly develop. Diseases provoke frequent infection upper respiratory tract in the form of tonsillitis, various types of sore throat and pharyngitis.

In some cases, lymph nodes can be affected in isolation, and sometimes tumors grow into other organs.

Elimination of tumor diseases and other problems with the mediastinum is carried out according to generally accepted standards of therapeutic influence.

mediastinum posterius, limited anteriorly by the tracheal bifurcation, bronchopericardial membrane and back wall pericardium, posteriorly - by the bodies of the IV-XII thoracic vertebrae, covered with prevertebral fascia. In the posterior mediastinum are the descending aorta and esophagus, azygos and semi-gypsy veins, sympathetic trunks, splanchnic nerves, vagus nerves, thoracic duct and lymph nodes. Currently, several drainage methods are known posterior mediastinum: a) through posterior extrapleural access from the back at the level lung root according to I.I. Nasilov (3, 5); b) through the cervical access with a longitudinal incision along the inner edge of the sternocleidomastoid muscle with the formation of a channel between the vessels, trachea, thyroid gland and esophagus down to the place of accumulation, pus and insertion, there of a drainage tube for - its suction (3, 6); c) through the pleural cavity by means of a wide anterolateral thoracotomy in the 7th intercostal space according to V.D. Dobromyslov (3); d) through the abdominal cavity with an upper-middle laparotomy incision according to B.S. Rozanov (7); e) transesophageal access with the introduction of drainage into the posterior mediastinum through the false passage at the site of perforation of the esophageal wall or its incision at the level of the abscess, made through the tube of the Mezlin esophagoscope according to A. Seiffert

Anatomical and surgical rationale for access to the upper floor abdominal cavity.

Access to the abdominal organs Incisions of the abdominal wall: longitudinal: median laparotomy: upper median (above the navel); lower median (below the navel); total (complete) from the xiphoid process to the pubis) with bypass of the navel on the left (the umbilical vein passes on the right); Open layer by layer : skin, subcutaneous tissue, superficial fascia, linea alba, parietal peritoneum Oblique incisions - along the direction of contraction of the oblique abdominal muscles Access: to the liver, gall bladder, spleen, vermis. appendix, etc. Transverse incisions - to expose the biliary tract, pylorus, stomach, spleen, POC (do not cross the transverse muscle) Combined laparotomy - a combination of longitudinal laparotomy with a transverse and oblique incision Thoracophreno-abdominal access (Quino, Petrovsky) - from bottom corner right scapula along the 7th intercostal space to the navel or with its border on the right Thoracolaparotomy - opening of the chest and abdominal cavity to access the esophagus, stomach, SVC, etc.) Thoracotomy in the 7th intercostal space + laparotomy from the costal arch to the white line. Pararectal approach - incision parallel to the lateral edge of the rectus abdominis muscle; Transrectal access - through the thickness of the rectus muscle above the middle of its apex. Paramedian access – above the medial edge of the rectus sheath (above or below the navel);

Ticket No. 21

1. Principles of operations on peripheral nerves: neurotomy, neurolysis, neurorrhaphy, plastic surgery.

neurorrhaphy (nerve suture) and neuroplasty (reconstructive plastic surgery). Neurotomy – intersection of nerves. This operation performed for spastic muscle paralysis, causalgia, and also to reduce the acid-producing function of the stomach during peptic ulcer duodenum (vagotomy). Nerve suture (neurorrhaphy) - distinguished according to indications and conditions of execution: - primary (performed during the initial surgical treatment of the wound); - secondary (early - up to 2-3 months after healing, late - after 3 months) suture. The requirements for a nerve suture are: 1) ideal comparison of the ends of the nerve trunk without displacement along the axis and plane, without compression and deformation, without interposition of surrounding tissues, with hermetically sealed epineurium; 2) suturing healthy areas of the nerve trunk with optimal performance electrical conductivity and tissue resistance. 3) atraumatic operation (gentle handling of the nerve trunk when isolating the nerve and applying a suture, atraumatic needles and microsurgical instruments, complete absence seam tension). To meet these requirements, they resort to: 1) isolating the nerve from the grooves, canals and intermuscular spaces over a considerable distance (allows you to “lengthen” the nerve by 2-3 cm); 2) to the movement of nerves into adjacent muscular-fascial beds (allows you to lengthen the nerve by 5-7 cm); 3) to bone resection (allows you to lengthen the nerve by 8-10 cm); 4) to the isolation of the nerve from scar tissue (neurolysis) with resection of its injured and scarred areas. If, when determining the indications and conditions for performing a suture, there is no confidence that the above requirements will be met, the application of a primary suture is not recommended; it is better to resort to performing a secondary early suture. Access to the nerve trunks is usually the same as to the vessels in which the nerves are located ( brachial plexus– subclavian, axillary arteries; median, ulnar nerves - brachial artery; femoral nerve – femoral artery; tibial nerve, common peroneal nerve - popliteal, posterior tibial artery). Direct access to the radial and sciatic nerves is carried out by incisions along their projection lines. The radial nerve is exposed in the upper and middle third of the posterior region of the shoulder in the brachiomuscular canal between the long and medial, and below - the external head of the triceps brachii muscle. Sciatic nerve exposed in the gluteal region and posterior muscular groove, retracting the biceps femoris muscle outward, semitendinosus and semimembranosus muscle inward. Neurolysis is the release of a nerve from scar tissue, for example, when scarring a hematoma (in fractures of the humerus, radius, leg bones, etc.) or when performing a secondary suture of the nerve after injury. The operation consists of careful and thorough excision of all scars that compress the nerve and penetrate its trunk . To excise scars inside the nerve trunk, they resort to the so-called internal neurolysis, when, under the optical magnification of a microscope, the epineurium is dissected and the scars between the nerve bundles are dissected. If scar changes If the nerve trunk is captured and intra-trunk neurolysis is impossible, resection of the affected area or resection of the so-called neuroma is performed - thickening of the proximal end of the nerve due to the growth of axial cylinders in it. Then the nerve is sutured. If it is impossible to make a suture, they resort to reconstructive plastic interventions. Neuroplasty is performed in a number of ways: - nerve plastic surgery with a bundle of cutaneous nerve segments, for example, the saphenous nerve; - plastic surgery of more functionally significant nerves with grafts from less significant ones. For example, if the median and ulnar nerves are damaged in the shoulder, elbow, or forearm, the ulnar nerve is used for restoration. median nerve; - connecting the central end of a less functionally significant nerve with a suture to the peripheral end of a more significant one (suturing the hypoglossal or accessory nerve to the facial nerve).

2. Anatomical and surgical rationale for access to organs chest cavity: heart, lung, esophagus.

All approaches to the organs of the thoracic cavity are divided into two groups: extrapleural and transpleural. When performing extrapleural approaches, exposure of the anatomical formations of the mediastinum occurs without depressurization of the pleural cavities. The possibility of performing these approaches is determined by the position and relationship of the anterior and posterior borders of the pleura. With transpleural approaches, one or two (with the so-called transbipleural approaches) pleural cavities are opened. Transpleural approaches can be used for operations on both the mediastinal organs and the lungs. To perform a longitudinal sternotomy, a skin incision is made along the midline above the sternum, starting 2–3 cm above the manubrium of the sternum and ending 3–4 cm below the xiphoid process. Then the periosteum of the sternum is dissected and shifted 2–3 mm to the sides from the cut line using a raspatory. IN lower section the wounds dissect the linea alba of the abdomen over several centimeters and bluntly (finger, swab) form a tunnel between the posterior surface of the sternum and the sternal part of the diaphragm. Protecting the underlying tissues with Buyalsky's scapula (or another method), a longitudinal sternotomy is performed. The edges are spread wide apart using a screw retractor, taking care not to damage the mediastinal pleura. After the operation is completed, the edges of the sternum are compared and secured with special staples or strong sutures. An anterolateral incision is made at the level of the fifth or fourth intercostal space. This is one of the most commonly used, “standard” accesses. The incision starts from the parasternal line and, continuing along the intercostal space, reaches the posterior axillary line. After dissection surface layers chest wall spread the edges of the wound with hooks and expose the intercostal muscles and the corresponding ribs, after which they begin to dissect the intercostal muscles and pleura. With a lateral approach, the chest cavity is opened along the V–VI ribs from the paravertebral to the midclavicular line. To perform a posterolateral approach. the soft tissue incision begins at the level of the spinous process of the III–V thoracic vertebra and continues along the paravertebral line to the level of the angle of the scapula (VII–VIII ribs). Having rounded the corner of the scapula from below, an incision is made along the sixth rib to the anterior axillary line. All tissues are sequentially dissected to the ribs. Pleural cavity opened along the intercostal space or through the bed of the resected rib. To expand surgical access, they often resort to resection of the necks of two adjacent ribs. Transverse sternotomy is used when it is necessary to widely expose not only organs, but also the vessels of the mediastinum and nearby areas. The incision is made along the fourth intercostal space from the mid-axillary line on one side, through the sternum, to the mid-axillary line on the opposite side.

The mediastinum is part of the thoracic cavity, which is located between the pleural sacs (left and right), in front it is limited by the sternum, in the back - by the spine, namely its thoracic region, the lower border of the mediastinum is the diaphragm, the upper is the upper aperture of the chest (in other words, the mediastinum is a certain group of organs that is located between the mediastinal parts of the parietal pleura of the lungs). Conditionally allocate two sections of the mediastinum : superior mediastinum and inferior mediastinum. The division is carried out along a horizontal plane; this plane passes through the border between the manubrium and the body of the sternum and the space between the fourth and fifth thoracic vertebrae(it is much easier to remember that the upper mediastinum is above the roots of the lungs, and the lower - below).

Superior mediastinum contains thymus or its replacement with age adipose tissue, ascending aorta, aortic arch with its three branches, trachea and the beginning of the main bronchi, brachiocephalic and superior vena cava, upper (relative to the sections located in the lower mediastinum) parts of the esophagus, both sympathetic trunks, azygos vein, thoracic lymphatic duct, vagus and phrenic nerves.

Inferior mediastinum divided into three parts: anterior mediastinum, middle and posterior.

• Anterior mediastinum located between the anterior part of the chest and also the anterior part of the pericardium. The anterior mediastinum includes the internal thoracic blood vessels (arteries and veins), as well as the anterior mediastinal, parasternal and prepericardial lymph nodes.
• Middle mediastinum determined by the boundaries of the anterior surface and posterior surface of the cardiac membrane. The middle mediastinum includes the heart and its pericardium, as well as the intrapericardial parts of large blood vessels, pulmonary arteries and veins, main bronchi, nerves of the diaphragm, lymph nodes.
• Posterior mediastinum is between back pericardium and the spine itself. (It is much simpler to say that in front of the heart is the anterior mediastinum, behind it is the posterior one, and the pericardial cavity, where the heart itself and something else is located, is the middle mediastinum). The posterior mediastinum includes part of the descending aorta, veins (hemizygos and azygos), the lower elements of the esophagus and sympathetic trunks, the thoracic lymphatic duct, vagus nerves, posterior mediastinal lymph nodes and prevertebral lymph nodes, as well as splanchnic nerves.

A mediastinal tumor is a neoplasm in the mediastinal space of the chest, which can vary in morphological structure. Often diagnosed benign neoplasms, but approximately every third patient is diagnosed with cancer.

There are a large number of predisposing factors that determine the appearance of a particular formation, ranging from addiction to bad habits And hazardous conditions labor, ending with metastasis of the cancer from other organs.

The disease manifests itself in large quantities bright severe symptoms, which are quite difficult to ignore. The most characteristic external signs include severe cough, shortness of breath, headaches and increased body temperature.

The basis diagnostic measures consists of instrumental examinations of the patient, the most informative of which is considered to be a biopsy. In addition, a medical examination and laboratory tests will be required. Treatment of the disease, regardless of the nature of the tumor, is only surgical.

Etiology

Despite the fact that tumors and cysts of the mediastinum are quite rare disease, its occurrence in most cases is due to the spread oncological process from others internal organs. However, there are a number of predisposing factors, among which it is worth highlighting:

• long-term addiction to bad habits, in particular smoking. It is worth noting that the more experience a person has of smoking cigarettes, the greater the likelihood of acquiring such an insidious disease;
• decreased immune system;
• contact with toxins and heavy metals– can be included here as conditions labor activity and unfavorable environmental conditions. For example, living near factories or industrial enterprises;
• constant exposure to ionizing radiation;
• prolonged nervous overstrain;
• poor nutrition.

A similar disease in equally occurs in both sexes. The main risk group consists of people of working age – from twenty to forty years. In rare cases, malignant or benign neoplasms of the mediastinum can be diagnosed in a child.

The danger of the disease lies in the wide variety of tumors, which may differ in their morphological structure, damage to vital organs and the technical complexity of their surgical excision.

The mediastinum is usually divided into three floors:

• upper;
• average;
• lower.

In addition, there are three sections of the lower mediastinum:

• front;
• rear;
• average.

Depending on the part of the mediastinum, the classification of malignant or benign neoplasms will differ.

Classification

By etiological factor Mediastinal tumors and cysts are divided into:

• primary – originally formed in this area;
• secondary – characterized by the spread of metastases from malignant tumors that are located outside the mediastinum.

Since primary neoplasms are formed from various tissues, they will be divided into:

• neurogenic tumors of the mediastinum;
• mesenchymal;
• lymphoid;
• thymus tumors;
• dysembryogenetic;
• germ cell - develop from the primary germ cells of the embryo, from which sperm and eggs should normally be formed. It is these tumors and cysts that are found in children. There are two peaks of incidence - in the first year of life and in adolescence- from fifteen to nineteen years.

There are several most common types of neoplasms, which will differ in their location. For example, to tumors anterior mediastinum can be attributed:

• neoplasms thyroid gland. They are often benign, but sometimes they are cancerous;
• thymoma and thymic cyst;
• mesenchymal tumors;

In the middle mediastinum the most frequent formations are:

• bronchogenic cysts;
• lymphomas;
• pericardial cysts.

A tumor of the posterior mediastinum manifests itself:

• enterogenous cysts;
• neurogenic tumors.

In addition, clinicians usually distinguish between true cysts and pseudotumors.

Symptoms

For quite a long period of time, tumors and cysts of the mediastinum can occur without expressing any symptoms. The duration of this course is determined by several factors:

• place of formation and volume of neoplasms;
• their malignant or benign nature;
• the rate of tumor or cyst growth;
• relationship with other internal organs.

In most cases, asymptomatic mediastinal tumors are discovered completely by accident - during fluorography for another disease or for preventive purposes.

As for the period of expression of symptoms, regardless of the nature of the tumor, the first sign is pain syndrome in the retrosternal region. Its appearance is caused by compression or germination of the formation into the nerve plexuses or endings. The pain is often moderate. The possibility of irradiation cannot be ruled out pain in the area between the shoulder blades, in the shoulders and neck.

Against the background of the main manifestation, other symptoms of mediastinal tumors begin to appear. Among them:

• fatigue and malaise;
• increased body temperature;
• severe headaches;
• bluish lips;
• dyspnea;
• swelling of the face and neck;
• cough - sometimes with blood;
• uneven breathing, even attacks of suffocation;
• heart rate instability;
• profuse sweating, especially at night;
• causeless weight loss;
• increase in the volume of lymph nodes;
• hoarseness of voice;
• night snoring;
• increased blood pressure;
• slurred speech;
• disruption of the process of chewing and swallowing food.

In addition to the above symptoms, myasthenic syndrome very often appears, which is manifested by muscle weakness. For example, a person cannot turn his head, open his eyes, or raise his leg or arm.

Similar clinical manifestations characteristic of mediastinal tumors in children and adults.

Diagnostics

Despite the diversity and specificity of the symptoms of such a disease, it is difficult to establish correct diagnosis based on them is quite difficult. For this reason, the attending physician prescribes the whole complex diagnostic examinations.

Primary diagnosis includes:

• a detailed interview with the patient will help determine the first time of onset and the degree of intensity of symptom expression;
• a clinician’s examination of the patient’s medical history and life history to determine the primary or secondary nature of the tumors;
• a thorough physical examination, which should include auscultation of the patient’s lungs and heart using a phonendoscope, examination of the condition of the skin, and measurement of temperature and blood pressure.

General laboratory techniques diagnostics do not have special diagnostic value, however, it is necessary to conduct clinical and biochemical analysis blood. A blood test is also prescribed to determine tumor markers that will indicate the presence of a malignant neoplasm.

In order to determine the location and nature of the neoplasm according to the classification of the disease, it is necessary to carry out instrumental examinations, among which:

Treatment

After confirmation of the diagnosis, benign or malignant tumor The mediastinum must be removed surgically.

Surgical treatment can be carried out in several ways:

• longitudinal sternotomy;
• anterolateral or lateral thoracotomy;
• transthoracic ultrasound aspiration;
• radical extended surgery;
• palliative removal.

In addition, if the tumor is malignant, treatment is supplemented with chemotherapy, which is aimed at:

• volume reduction malignant formation– carried out before the main operation;
• final liquidation cancer cells, which may not have been completely removed during surgery;
• elimination of a tumor or cyst - in cases where surgical therapy cannot be performed;
• maintaining the condition and prolonging the patient’s life – when diagnosing a severe form of the disease.

Can be used as well as chemotherapy radiation treatment, which can also be the main or auxiliary technique.

There are several alternative methods fight against benign tumors. The first of them consists of a three-day fast, during which you need to refuse any food, and you are allowed to drink only purified water without gas. When choosing such treatment, you must consult with your doctor, since fasting has its own rules.

Therapeutic diet, which is part complex therapy, includes:

• frequent and fractional food consumption;
• complete rejection of fatty and spicy foods, offal, canned food, smoked meats, pickles, sweets, meat and dairy products. It is these ingredients that can cause the degeneration of benign cells into cancerous ones;
• enriching the diet with legumes, fermented milk products, fresh fruits, vegetables, cereals, dietary first courses, nuts, dried fruits and herbs;
• cooking food only by boiling, steaming, stewing or baking, but without adding salt and fat;
• plenty of drinking regime;
• control over the temperature of food - it should not be too cold or too hot.

Besides this, there are several folk remedies that will help prevent the onset of cancer. The most effective of them include:

Potato flowers will help
prevent cancer

• potato flowers;
• hemlock;
• honey and mumiyo;
• golden mustache;
• apricot kernels;
• sagebrush;
• white mistletoe.

It is worth noting that starting such therapy on your own can only aggravate the course of the disease, which is why before using folk recipes You should consult your doctor.

Prevention

There are no specific preventive measures, which can prevent the appearance of a tumor in the anterior mediastinum or any other location. People need to follow a few general rules:

• give up alcohol and cigarettes forever;
• follow safety rules when working with toxins and poisons;
• If possible, avoid emotional and nervous stress;
• follow nutritional recommendations;
• strengthen immunity;
• undergo fluorographic examination annually for preventive purposes.

There is no unambiguous prognosis for such a pathology, since it depends on several factors - localization, volume, stage of development, origin of the tumor, age category the patient and his condition, as well as the possibility of surgery.

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