Tumors of the Mediastinum

Tumors of the mediastinum are rare in pediatrics but may present in dramatic fashion. Respiratory symptoms such as cough, stridor, and wheezing are present in more than 60% of patients on presentation. A small but significant subset of patients will present with respiratory failure, superior vena cava syndrome, or other immediately life-threatening complaints. Greater than 50% of these masses are malignant, but even nonmalignant tumors can obstruct vital structures and present in a critical fashion. This review seeks to explain the most common mediastinal tumors in childhood and presents a reasonable algorithm for initial workup and treatment by the primary care or emergency department physician. To optimize outcome, these children are best served by a tertiary hospital where the availability of pediatric medical and surgical subspecialists and potential life-saving interventions are possible.