Main Thoracic Tumors in Pediatric Age

Pediatric thoracic tumors are a heterogeneous group of neoplasms, accounting for 15–20% of all malignant tumors in childhood. Primary and metastatic thoracic tumors are classified according to where they originate, i.e., the lung parenchyma, the airways, the mediastinum, and the chest wall. The vast majority of pediatric thoracic tumors arise from the mediastinum, either posterior or anterior compartments. The imaging evaluation of these children is initially directed by clinical presentation and usually begins with a chest radiograph. Further imaging with CT, MRI, or rarely ultrasonography may be performed to better detect, localize, or characterize the lesion(s). These diseases require a complex approach in which a combination of chemotherapy, radiotherapy, and surgery play a fundamental role. Treatment efforts are directed toward improving quality of life through reduced surgery-related morbidity. A minimally invasive approach offers, whenever possible, proved advantages leading to an earlier transition to postoperative adjuvant therapy. A thorough patient-specific discussion evaluating pros and cons should address the most appropriate surgical strategy and approach. The complexity of a multidisciplinary approach requires specialized centers, where all the professional figures needed are trained and experienced to guarantee the best possible treatment for these little patients.