Medicina Translacional
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Clinical and Imaging Findings Useful in the Differential Diagnosis of Most Common Childhood Mediastinal Tumors

Brillantino C, Rossi E, Tambaro FP, Minelli R, Bignardi E, Cremone G, Zeccolini R and Zeccolini M

The mediastinum is the most common location of childhood intrathoracic tumors. The mediastinum is composed of three compartments: prevascular, visceral and paravertebral. Mediastinal tumors are classified according to the site of origin. At the time of diagnosis, children are often asymptomatic and lesions may be observed on screening examinations. However, large tumors can cause severe symptoms, due to local invasion and compression of vessels, nerves, trachea, bronchi and esophagus, within the mediastinum. Integration of clinical information and radiographic findings enables diagnosis. Chest radiography is obviously the first imaging procedure that is performed in children with symptoms referable to the thorax. Once a mediastinal lesion is identified by chest radiography, "cross-sectional imaging methods" are performed. In particular, computed tomography is valuable in demonstrating tumor size and morphology, its exact anatomical location and its relation with the surrounding vital mediastinal structures. This article reviews the more common childhood mediastinal tumors considering clinical manifestations and characteristic imaging findings in order to make a correct diagnosis.