Anterior Mediastinal Masses

Abstract

Anterior mediastinal masses can affect the airway, breathing, and circulation (ABC) and often entail a well-planned multidisciplinary team approach with regard to management. The anesthetic management of these cases depends on the individual’s risk and symptomology. Anesthesia can range from standard general to awake cannulation for extracorporeal membrane oxygenation depending on severity of presentation and extent of airway and cardiovascular compromise. It is crucial to avoid an “intubate, cannot ventilate” situation or cardiovascular collapse. Patients who present with the superior vena cava syndrome can be particularly challenging. The goal of this chapter is to describe a case-based approach to anterior mediastinal masses focused on the ABCs. By reviewing the etiology of mediastinal masses, examining the presentation of symptoms, exploring the pathophysiology and the risks to the ABCs, the authors emphasize the need for a multidisciplinary approach to care for these patients effectively.