21st February 2025

Presentation of mediastinal masses

Mediastinal masses are often asymptomatic and are frequently identified incidentally on thoracic imaging. 

Symptoms and signs will reflect the nature and location of the mass and the structures it involves or compresses. Involvement of the recurrent laryngeal nerve can lead to hoarseness, and damage to the sympathetic chain may result in Horner’s syndrome. Bulky mediastinal masses may cause dysphagia via oesophageal compression.

Emergency presentations are possible and include airway compression and superior vena cava obstruction.