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.