Symptoms result from spread of the tumor into surrounding tissues and include:

• Cough
• Shortness of breath
• Chest pain
• Limited exercise tolerance
• Fatigue

On physical examination, a physician may see signs of congestive heart failure and increased pressure in the chest cavity. Diagnosis is made using the following tests:

• History and physical examination
• CT scans of the chest, abdomen, and pelvis
• Elevated levels of b-HCG and AFP in the blood
• Mediastinoscopy and biopsy -- use of a special scope to look in the mediastinuman (mediastinoscopy) and remove a piece of the tumor (biopsy)
• Anterior mediastinotomy -- open surgery to remove the tumor or part of it