Clinical spectrum of primary mediastinal tumors: a comparison of adult and pediatric populations at a single Japanese institution.
OBJECTIVE
The purpose of this study was to review our Japanese institutional experience of mediastinal tumors and to compare differences in the clinical spectrum between adults and children.


METHODS
We retrospectively reviewed the records of 806 patients (676 adults and 130 children) between 1951 and 2000 at our institution.


RESULTS
There were 244 thymomas (36%), 106 germ cell tumors (16%), 95 congenital cysts (14%), 82 lymphomas (12%), 76 neurogenic tumors (11%), and 24 thyroid tumors (4%) in adult patients. There were 60 neurogenic tumors (46%), 24 germ cell tumor (19%), 17 lymphoma (13%), 10 congenital cysts (8%), and 5 thymomas (4%) in the pediatric patients. There was a significant higher incidence of neurogenic tumors and a lower incidence of thymomas and thyroid tumors in children than adults. The most common location was the anterior compartment (68%) in adults and the posterior compartment in children (52%). The prevalence of malignancy in pediatric patients was lower than adults (37% vs. 47%; P < 0.05). Symptoms due to compression or direct invasion into adjacent structures may have caused the higher incidence of dyspnea or respiratory distress in the pediatric group compared to the adults (15.4% vs. 4.0%; P < 0.001). There were fewer incidences of facial edema in children compared to adults (2.6% vs. 10.7%; P < 0.02). Emergent operations were required more often in the pediatric group than the adult group.


CONCLUSIONS
We demonstrated definite differences in histologic distribution, location, and symptomatology in mediastinal tumors between adult and pediatric populations, which should be considered in the evaluation and planning of a therapeutic modality for mediastinal tumors.
Department of Thoracic Surgery, Toneyama National Hospital, Toneyama, Toyonaka City, Osaka, Japan. stakeda@toneyama.hosp.go.jp
Shin-ichi
S
Takeda
Shinichiro
S
Miyoshi
Akinori
A
Akashi
Mitsunori
M
Ohta
Masato
M
Minami
Meinoshin
M
Okumura
Akira
A
Masaoka
Hikaru
H
Matsuda
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D018237:Germinoma / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D012189:Retrospective Studies; D013945:Thymoma / Q000453:epidemiology; D013953:Thymus Neoplasms / Q000453:epidemiology