Primary mediastinal tumors in children--comparison with mediastinal tumors in adults

During the past 43 years, 628 patients with a primary mediastinal tumor underwent surgical operation in our institution. Of those patients, 106 patients (16.9%) were children of 15 yr of age or less and 522 patients (83.1%) were adults. 47 (44.3%) of the 106 children had neurogenic tumors, while 21 patients (19.8%) had a teratoma. 189 (36.2%) of the 522 adults had thymoma and 89 patients (17.1%) had teratoma. In the 106 children there were 71 benign tumor patients (66.9%) and 35 malignant tumor patients (33.1%). There were 277 (53.1%) benign and 245 (46.95) malignant tumors in the 522 adults. The adults had significantly more malignant tumors than the children (p < 0.01). In our series of malignant mediastinal tumors in children, 14 patients (13.3%) had a lymphoma and 11 patients (10.5%) had a neuroblastoma. On the other hand, in the adults, 127 patients (24.3%) had a thymoma and 66 patients (12.6%) had a lymphoma. Regarding benign mediastinal tumors, in children, 30 patients (28.5%) had a ganglioneuroma and 19 patients (18.0%) had a teratoma. In the adults, 68 patients (13.0%) had a teratoma and 62 patients (11.9%) had a thymoma. In the clinical manifestation, 51 child patients (48.1%) and 191 adult patients (36.6%) were asymptomatic. As symptoms due to compression or direct invasion to adjacent structures, dyspnea was seen in 16 child patients (15.1%), and chest pain occurred in 59 adult patients (11.3%). Dyspnea was significantly more common in children than in in adults (p < 0.01). Emergency operations were performed in children more than in adults.