Posterior mediastinal masses

A)Posterior mediastinal masses

Include the following

-Esophageal masses such as esophageal carcinoma.

-Vertebral masses such as Pott's abscess. 

-Neurogenic tumors:

1-Is the most common tumor affecting posterior mediastinum.

2-May arise from peripheral nerves, sympathetic ganglia or paraganglia.

3-Peripheral nerve tumors include schwannoma(32%), neurofibroma(10%) and malignant tumors of nerve sheath.

4-Tumors of sympathetic ganglia include ganglioneuroma(25%), ganglio-neuroblastoma(15%), neuroblastoma(15%) where the latter two are tumors of pediatric age.

5-Paraganglion tumors include paraganglioma(4%), and pheochromocytoma.

B) Neurogenic tumors are the most common tumors can be mistaken as bronchogenic carcinoma.

To differentiate between them, look to the border of the lesion, if it is smooth, think neurogenic tumor as it is a benign lesion, but if the border is irregular or spiculated, think bronchogenic carcinoma. Again look if the lesion is entering inside the spinal canal, if it is, think neurogenic tumor.

C) Lesions mimicking mediastinal masses:

1-Bronchogenic carcinoma:

-Is the only mass mimicking mediastinal mass.

-Mediastinal masses mimicking bronchogenic carcinoma are neurogenic tumors(posterior mediastinum) and thymic tumors(anterior mediastinum).