Thoracic Mass, Pediatric

• • Resectable lung metastases

  • -Osteogenic sarcoma

    -Soft-tissue sarcoma

    -Wilms tumor

  • Primary lung tumors

  • -Bronchial "adenoma": Malignant (most common)

    -Bronchogenic carcinoma (90% mortality rate)

    -Pulmonary blastoma, sarcomas, inflammatory pseudotumor (benign)

    -Hamartoma (benign)

  • Mediastinal tumors

  • -Neurogenic (posterior mediastinum, include neuroblastoma, ganglioneuroblastoma, and ganglioneuroma)

    -Neurofibroma, lymphoma, teratoma (anterior mediastinum)

  • Chest wall

  • -Ewing sarcoma

    -Chondrosarcoma

    -Liposarcoma

Symptoms and Signs

• • Cough with sputum

  • Hemoptysis

  • Chest pain

  • Dyspnea

  • Fever

  • Postobstructive pneumonia

Laboratory Findings

• • Leukocytosis

Imaging Findings

• • Chest film: Can identify mass

  • Chest CT: Can identify various etiologies of chest mass and relative location

• • Evaluate for sites of primary disease

• • History and physical exam

  • Chest x-ray

  • Chest CT

  • Bronchoscopy for central lesions

  • Thoracoscopy and possible biopsy

Surgery

• • Formal resection (wedge or lobectomy) indicated for nearly all of above etiologies or excision of mediastinal lesions

Prognosis

• • Excellent for most pulmonary neoplasms

  • -Outcome better for neuroblastomas in chest than for those in abdomen

    -Bronchogenic carcinoma, 80% mortality

References