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Purpose: to verify voice and swallowing implications in patients diagnosed with tumors in the mediastinum. Methods: the study was carried out with 21 individuals aged between 18 and 60 years, with a diagnosis of tumors in their mediastinum. Data collection was performed at Oncology, OncoHematology and Thoracic Oncology Surgery ambulatory, and in the wards of the aforementioned clinics at an oncology reference hospital. The data was obtained by applying a questionnaire, and by evaluating voice and swallowing, using CAPE-V and O'Neil protocols, respectively. Results: there was a higher prevalence of females with mean age at 40 years. A higher prevalence of tumors in the anterior region of the mediastinum and non-Hodgkin's lymphomas was found, however, Hodgkin's lymphomas presented worse results in all the parameters of the voice evaluation. Fourteen subjects presented some degree of dysphagia, ranging from mild to moderate. Conclusion: patients with tumors in the mediastinum have significant impairments in voice and swallowing functions, especially when they are located in the anterior mediastinal region and Hodgkin lymphomas. RESUMO Objetivo: verificar as implicações na voz e na deglutição em pacientes com diagnóstico de tumores localizados no mediastino. Métodos: o estudo foi realizado em 21 indivíduos com idades entre 18 e 60 anos, com diagnóstico de tumores localizado no mediastino. A coleta de dados foi realizada nos ambulatórios de Oncologia Clínica, OncoHematologia e Cirurgia Torácica Oncológica, e nas enfermarias das clínicas acima mencionadas de um hospital de referência em Oncologia. Os dados foram obtidos por meio da aplicação de um questionário próprio para a pesquisa, e da avaliação da voz e da deglutição, por meio dos protocolos CAPE-V e O’Neil, respectivamente. Resultados: houve maior prevalência do sexo feminino com média de idade aos 40 anos. Observou maior prevalência de tumores na região anterior do mediastino e dos linfomas do tipo não Hodgkin, no entanto, os linfomas do tipo Hodgkin apresentaram piores resultados em todos os parâmetros da avaliação de voz. Quanto à disfagia, 14 sujeitos apresentaram algum grau de disfagia, compreendendo da disfagia discreta a moderada. Conclusão: pacientes com tumores no mediastino apresentam comprometimentos significantes nas funções de voz e deglutição, principalmente nos tumores localizadas na região anterior do mediastino e Linfomas do tipo Hodgkin.

A thymoma often occurs in patients with myasthenia gravis, but the development of multiple thymoma is very rare. The authors report the radiologic and pathologic findings of multiple invasive thymoma in a 59-year-old male with myasthenia gravis.

Mature teratoma is a benign tumor composed of a number of different types of well-differentiated tissues. Mature teratomas of the mediastinum usually grow slowly and are commonly asymptomatic. We report a case of mediastinal mature teratoma with rapid growth resulting in rupture

The authors report a case of Letterer-Siwe syndrome presenting primarily as a mediastinal mass erroneously diagnosed as cystic thymoma. Although thymic involvement in Letterer-Siwe syndrome is common, only 2 previous cases have involved a mediastinal mass.

1223 patients underwent aspiration biopsy with a diagnostic yield of 86.4%; 24.2% of the patients had a small pneumothorax, but only 4.4% required treatment; one patient developed a moderate hemothorax. The method, problems, and complications including morbidity and mortality are discussed. The relative success of aspiration biopsy with different lesions of the lung and mediastinum is identified.

Multiple primary tumors are a common mode of presentation in familial neuroblastoma but must be differentiated from metastatic disease. The cases of 2 siblings with multiple neuroblastomas are presented and 44 additional cases of neuroblastoma reviewed. It was found that primary tumors localize to the posterior mediastinum, the adrenals, and the paravertebral ganglia whereas metastatic disease is found in the anterior and middle mediastinum, bones and para-aortic nodes. Based on these observations, the diagnosis of multiple primary tumors can be made and should lead to early consideration of familial neuroblastoma.

Of 38 patients with ascites caused by neoplasm studied by mediastinal lymphoscintigraphy and 99mTc-sulfur colloid injection, 32 had no activity above the diaphragm and 4 had slight activity. Only 2 patients had normal studies. Of 14 patients with ascites of other cause or with no ascites, 10 had normal studies. Three patients with known mediastinal disease had a partial distribution of activity, and only one had no activity above the diaphragm. These findings suggest that blockage to the normal lymphatic pathways draining the peritoneal cavity may be one of the mechanisms involved in the accumulation of ascites in malignant disease.

Zur Feststellung derBeziehungen maligner intrathorakaler Tumoren zum System der V. c. s. wurden der venose Katheterismus und die mediastinale Venographie ausgefuhrt. Der Katheterismus mit gleichzeitiger Druckmessung erlaubt uns den cardial bedingten vom mechanisch entstandenen venosen Hochdruck zu unterscheiden. Er bietet einen Anhalt fur die obere Begrenzung eines gefasobturierenden Prozesses. Uber die Ausdehnung und Konfiguration des gefaseinengenden Prozesses gibt uns die mediastinale Venographie Aufschlus. Diese an einigen Beispielen demonstrierte, relativ einfache und gefahrlose Methode kann fur die diagnostische und praoperative Beurteilung, insbesondere fur die operative Indikationsstellung entscheidende Bedeutung gewinnen.

Summary. Twenty-four cases of tumours and cysts of the mediastinum are described, and in-clude two cases of posterior mediastinal goitre, 1 haemangioma, and 1 lymphatic cyst. A survey of the literature of some 600 tuniours and cysts has been made. A brief description of the various types tumours and cysts is given.

A case of successful surgical removal of benign mediastinal hemangioma in an infant is reported. Since these tumors cannot be differentiated from other mediastinal tumors, early exploratory operation is advisable. The size, shape and position of hemangiomata are not diagnostic, and the normal aids to diagnosis are not exceedingly helpful. Frequently, rapid increase in size from hemorrhage into the tumor with symptoms of mediastinal compression necessitates early operation. Although this type of tumor is rare, more cases are being reported and a greater number of surgical cures are possible. The malignant variety is difficult to differentiate at operation from a benign form with extensive infiltration into and binding of mediastinal structures. In such cases resection is well nigh impossible.

1.1. This report concerns a benign skin-covered mediastinal teratoma bearing a remarkable resemblance to the so-called "fetal parasite." As far as we know this is only the third such case ever to be reported in this location. An interesting sidelight was the lipoid pneumonia which the tumor produced in the middle lobe due apparently to the liberation of sebaceous material by the outer covering of skin. The patient remains well four years following excision of the tumor and the middle lobe. 2.2. The subject of mediastinal teratomas is reviewed, particular attention being devoted to their derivation.

The heart is involved by lymphoma in approximately 20 per cent of patients dying of this disease. Because of a low index of suspicion antemortem recognition of such involvement is infrequent even when cardiac manifestations are present. The clinical and pathologic features of lymphomatous heart disease are briefly reviewed and two illustrative cases presented. Patients with known lymphoma should be carefully observed for signs of cardiac invasion and lymphoma should be considered in the differential diagnosis of heart disease of obscure etiology.

SUMMARY Two cases of primary liposarcoma of the mediastinum are presented, bringing the total number of reported cases to 19. The clinical and laboratory findings and the natural history of these patients are reviewed. Two patients presented a syndrome of constrictive pericarditis. Response to surgery and to radiotherapy has been short-lived in the majority of these cases. Since the ratio of benign to malignant adipose tissue tumors of the mediastinum is three to one, the importance of an early histologic diagnosis is stressed.

It is of importance to recognize a right aortic arch not only for the occasional symptoms which may be produced by it, but more so, to differentiate it from mediastinal tumors and diseases of lymph nodes. The seven selected cases presented in this article, emphasize the diagnostic and differential diagnostic problems that we have encountered. Three cases were presented in which the investigation for mediastinal and pulmonary pathology revealed a right aortic arch as an accidental finding. These three patients had somewhat dilated, elongated and tortuous aortic vessels. Their routine posterior-anterior chest films were not suggestive of right aortic arch. Two cases presented a bilateral upper mediastinal density suggestive of right aortic arch with additional mediastinal pathology. The esophagram revealed a right aortic arch in one case and excluded that diagnosis in the other. In both cases the manubrium sterni added to the diagnostic problems encountered. Positional deviations of the sternal manubrium are not infrequent. Two cases were shown with enlarged mediastinal lymph nodes simulating right aortic arch.

The roentgen appearance of the normal azygos vein was first described by Ottonello in 1932. It casts an ovoid or almond-shaped shadow in the right tracheobronchial angle, seen to best advantage on frontal laminagrams of the chest. The width of the normal azygos vein in adults has been reported not to exceed 6 mm. (Fleischner and Udis). Dilatation of the azygos vein has been described under various pathologic circumstances, including right-sided heart failure, portal venous hypertension, obstruction of the superior or inferior vena cava, and absence of the inferior vena cava. Particularly in the latter case, the azygos and hemiazygos venous systems may serve as important collateral channels for return of blood to the right side of the heart. It is our purpose to record the case of a healthy 19-year-old white male who was rejected from military service because a routine induction chest roentgenogram revealed a “mediastinal tumor” (Fig. 1). At a subsequent exploratory thoracotomy, a huge azygos vein was foun...

Summary 1. A case of primary lymphosarcoma of the mediastinum occurring in a 7-month-old infant is reported. Rapid disappearance of the neoplasm followed 1,360 r. units of x-ray therapy and the child has been asymptomatic and apparently cured for the past twelve years. 2. The diagnosis of lymphosarcomais not a hopeless one. Apparent cures do occur following prompt and adequate therapy.