A multidisciplinary approach to the management of anterior mediastinal masses in children

Journal of Pediatric Surgery
Shannon N AckerDavid A Partrick

Abstract

Anterior mediastinal masses (AMM) pose a diagnostic challenge to surgeons, oncologists, anesthesiologists, intensivists, and interventional radiologists as induction of general anesthesia can cause airway obstruction and cardiovascular collapse. We hypothesized that in the majority of patients, diagnosis can be obtained through biopsy of extrathoracic tissue. We performed a retrospective review of all patients in the solid tumor oncology clinic with a diagnosis of AMM between 2002 and 2012 including preoperative evaluation and management prior to obtaining a tissue diagnosis, clinical course and complications. We identified 69 patients with AMM (mean age 12.2±4.4years, 64% male) secondary to Hodgkin lymphoma (34), Non-Hodgkin lymphoma (26), and other diagnoses (9). The majority of patients (56, 81.2%) underwent biopsy of tissue outside of the mediastinal mass. Local anesthesia with sedation was used for successful biopsy in 21 (30%) patients. Four (5.8%) required repeat biopsy due to inadequate sample obtained at initial procedure. Three (4.4%) suffered respiratory complications with no fatalities or severe complications. Our data demonstrate that in the majority of children with AMM, tissue biopsy can be successfully obtained ...Continue Reading

References

Oct 10, 2001·Chest·O W HnatiukA Sierra
Jul 11, 2003·Chest·Roberto TorchioJoseph Milic-Emili
Jan 11, 2007·Current Opinion in Anaesthesiology·Peter Slinger, Cengiz Karsli
Jul 23, 2011·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Randal S Blank, Duncan G de Souza

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Citations

May 3, 2019·Archives of Disease in Childhood. Education and Practice Edition·Katherine GreenDanny Cheng
Sep 11, 2019·International Anesthesiology Clinics·B Randall Brenn, Alexander K Hughes
Mar 8, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Brian RadvanskyMichelle Capdeville
Oct 30, 2021·Paediatric Anaesthesia·Aileen Tan, Judith Anne Nolan

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