Chest Cavity Conditions

The mediastinum is the central portion of the chest between the lungs. Any growth found in this cavity is referred to as a mediastinal mass. These growths can be malignant (cancerous) or benign. When the mass is small, a patient may have no noticeable symptoms. Mediastinal tumors are typically found on a chest X-ray taken for other reasons. Symptoms may include:

Advanced diagnostic methods are often used to make an accurate diagnosis, including:

Most benign mediastinal tumors require surgical excision in order to alleviate symptoms and prevent further growth.

Paraesophageal hernias occur when a patient's stomach protrudes through the diaphragm into the chest next to the esophagus. The esophagus passes into the stomach through the opening in the diaphragm. Weakened muscles allow the stomach muscles to protrude into the chest, creating the hernia. The diaphragm squeezes stomach acid and other contents back up into the esophagus, causing heartburn and difficulty swallowing.

Treatment includes:

Surgery is used for those who fail standard medical treatments. Typically, our thoracic surgeons will recommend laparoscopic repair of paraesophageal hernias, which uses a minimally invasive approach.

The pleural space lies between the lungs and chest wall. Pleural effusion is the build-up of fluid in this area. Many underlying benign and malignant conditions can cause this, and both benign and malignant tumors can grow from the pleura.

A higher risk for developing pleural effusions is evident in those who have other medical conditions such as heart failure, liver failure, kidney failure, or severe pneumonia. Asbestos exposure is also a risk factor for developing a pleural tumor.

Symptoms of pleural effusion include:

Several methods may be used to make an accurate diagnosis, including:

For benign cases, treatment may consist of putting medicine into the pleural cavity to keep the fluid from returning. Sometimes a specialist will surgically strip scar tissue from the lung so it can fully expand and fill the pleural cavity. In cases of malignant tumors, treatment may involve removing part of the pleura or lung.

Pectus excavatum is caused when the bones of the ribs and sternum do not form properly, causing a caved-in appearance of the chest. The standard treatment is a surgical procedure that requires a large incision across the chest. However, our thoracic surgeons offer a minimally invasive approach for the least possible scarring.

Thoracic outlet syndrome (TOS) is caused when the nerves and blood vessels between the base of the neck and armpit are compressed. If the shoulder muscles in the chest are not strong enough to hold the collarbone in place, it can slip down and forward, putting pressure on the nerves and blood vessels and reducing blood flow to the hands.

This can result from:

Symptoms

Thoracic outlet syndrome is a difficult condition to diagnose and treat. Because it shares many of the same symptoms as other upper extremity conditions, such as carpal tunnel syndrome, it is sometimes misdiagnosed.

The most common symptoms of TOS are:

Symptoms become worse with repetitive or overhead activities.

Treatment

Treatment for TOS includes physical therapy, medications, and weight loss. The goal is to modify postural habits, relieve muscle tension, improve alignment, and increase nerve gliding. Rest, adjustments to how you perform daily activities, oral anti-inflammatory medications, and steroid injections may be recommended.

For patients who have not found relief, surgery may be required.

There are two approaches to TOS surgery: