Primary mediastinal tumors in children and adults: a clinicopathological spectrum.

Background: Mediastinal tumors are a heterogenous group of unrelated neoplasms that share the mediastinal anatomical location. There are no local publications regarding mediastinal masses, as such the clinical and pathological characteristics of this group of tumors in our population has been overlooked. The study aims to describe the mediastinal masses clinicopathological spectrum in children and adults.

Methods: With the objective to compare the clinicopathological spectrum of mediastinal tumors among children and adults we retrospectively review the medical charts and pathology reports of 110 patients with primary mediastinal masses between 2010 and 2022 at Hospital San Vicente Fundación and University of Antioquia pathology laboratory (Medellín, Colombia).

Results: We found statistically significant differences, regarding tumor location, tumor type, histological type and presenting complaint. The anterior mediastinal compartment was the most frequent location considering all tumors, with a statistically significant difference (P=0.042) favoring the adult group. A significant difference was also present in adults' anterior compartment for malignant tumors (P=0.02), which can be explained in both situations by the exclusive incidence of thymic tumors in the adult's anterior compartment. In contrast, malignant tumors show statistically significant differences (P=0.001) in the posterior compartment of the child group, associated with the high incidence of neurogenic tumors in this group (P=0.001), specifically neuroblastoma (P=0.002). Fever in the child group (P=0.02), was the most statistically significant presenting complaint related exclusively with lymphoid tumors.

Conclusions: mediastinal mass epidemiological data vary according to populations; thus it is of utmost importance to acknowledge local patients' characteristics in order to narrow the clinical and pathological differential diagnosis.