CHEST (THORACIC) SURGERY – The Mediastinum
Chest surgery refers to surgery performed by specialists (thoracic surgeons) for organs in the chest. This includes lungs heart, oesophagus, diaphragm and nerves.
There is a potential space in the chest which is known as the mediastinum. Depending on the location, the mediastinum can be divided into superior, anterior, middle and posterior mediastinum. The mediastinal space can be affected by tumour involvement.
The anterior mediastinum contain an organ called the thymus gland. This gland may form tumours called thymomas, thymic carcinoma. Other masses in the anterior mediastinum may be large goitres from the thyroid gland, lymphoma, and germ cell tumours. Diagnosis for the different cancers may need special techniques. Ranging from needle biopsies, to mediastinoscopy or removal by surgery.
Cancer surgery will depend on what the tissue diagnosis is. For example, thymomas are often removed in its entirety, the cancer surgery is called total thymectomy.
Same for germ cell tumours. In some cases, cancer surgery can be offered as cure by removing the entire tumour.
For lymphomas in the mediastinum, the cancer surgery may be just a biopsy to obtain tissue diagnosis.
For the posterior mediastinum, cancer may arise from nerve tissues. These are mostly benign but will need to be evaluated with CT or MRI ordered by a cancer specialist or a thoracic oncologist. Some of these tumours may involve the spinal canal and may cause paralysis if not surgically treated.