and ganglioneuromas, are found in the posterior compartment Neurogenic tumors are the most common cause of mediastinal masses, with lymphomas and germ cell tumors being second and third in frequency Infection is an uncommon cause of mediastinal node enlargement, but when present, is frequently caused by histoplasmosis Thymic enlargement may mimic an anterior mediastinal mass FIGURE 124.11 Mediastinal tumors in children Differential diagnosis is based on anatomic location within the mediastinum Goal of Treatment Since the meadiastinum is a limited and confined space, lesions in this anatomic area can cause respiratory and circulatory compromise, which may be the presenting symptoms Prompt identification of a space-occupying mediastinal mass and an awareness of the relevant anatomy are critical These patients require careful attention and early consultation with appropriate specialists for complete workup and expeditious treatment Clinical Considerations Clinical Recognition Mediastinal masses frequently present with chest pain or respiratory symptoms as a result of airway compression Patients may present with cough, wheezing, recurrent respiratory infections, bronchitis, atelectasis, and hemoptysis Dysphagia and hematemesis may occur with compression of the esophagus Superior vena cava syndrome is a rare complication, usually in association with a rapidly growing tumor Orthopnea may occur with vascular compression If the