Management of children and adolescents with a critical airway due to compression by an anterior mediastinal mass

Perger, Lena; Lee, Edward Y.; Shamberger, Robert C.

doi:10.1016/j.jpedsurg.2008.02.083

Cited by 67 publications

(58 citation statements)

References 27 publications

(35 reference statements)

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“…For determining the caliber of the trachea, published standard mean tracheal cross-sectional areas in normal children and adolescents can be used for reference as listed in Figure 9 (49,50). Finally, intraluminal abnormalities (eg, central airway neoplasm, foreign body aspiration) and mediastinal abnormalities (eg, vascular rings and sling, lymphadenopathy) may produce intrinsic or extrinsic effects on the central airways, respectively (5,21,22,46,51). Because of their characteristic CT appearances on end-inspiratory images, these entities can generally be easily distinguished from TM.…”

Section: Paired End-inspiratory and End-expiratory And Paired Endinspmentioning

confidence: 99%

Tracheobronchomalacia in Infants and Children: Multidetector CT Evaluation

Lee

Boiselle²

2009

Radiology

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109

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Tracheobronchomalacia (TBM) is the most common congenital central airway anomaly, but it frequently goes unrecognized or is misdiagnosed as other respiratory conditions such as asthma. Recent advances in multidetector computed tomography (CT) have enhanced the ability to noninvasively diagnose TBM with the potential to reduce the morbidity and mortality associated with this condition. Precise indications are evolving but may include symptomatic pediatric patients with known risk factors for TBM and patients with otherwise unexplained impaired exercise tolerance; recurrent lower airways infection; and therapy-resistant, irreversible, and/or atypical asthma. With multidetector CT, radiologists can now perform objective and quantitative assessment of TBM with accuracy similar to that of bronchoscopy, the reference standard for diagnosing this condition. Multidetector CT enables a comprehensive evaluation of pediatric patients suspected of having TBM by facilitating accurate diagnosis, determining the extent and degree of disease, identifying predisposing conditions, and providing objective pre- and postoperative assessments. In this article, the authors present a step-by-step primer of multidetector CT imaging for evaluating infants and children with suspected TBM, including clinical indications, patient preparation, multidetector CT techniques and protocols, two- and three-dimensional processing of multidetector CT data, and image interpretation. The major aim of this article is to facilitate the reader's ability to successfully employ multidetector CT imaging protocols for evaluation of TBM in infants and children in daily clinical practice.

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Section: Paired End-inspiratory and End-expiratory And Paired Endinspmentioning

confidence: 99%

Tracheobronchomalacia in Infants and Children: Multidetector CT Evaluation

Lee

Boiselle²

2009

Radiology

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109

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“…Like other investigators,5, 6 we assess severity using risk factors such as severe narrowing or complete occlusion of one or both mainstem bronchi, >50% reduction of the tracheal cross-sectional area, pericardial or pleural effusion, and signs or symptoms of superior vena cava obstruction. Patients who are at a higher risk should be initiated on steroids, tumor lysis prevention, and diagnosis-relevant chemotherapy and receive an urgent radiation oncology consultation.…”

Section: Discussionmentioning

confidence: 99%

Palliative radiation therapy for superior vena cava syndrome in metastatic Wilms tumor using 10XFFF and 3D surface imaging to avoid anesthesia in a pediatric patient—a teaching case

Rwigema

Lamiman

Reznik

et al. 2017

Advances in Radiation Oncology

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“…Indeed, 79% (15/19) of asymptomatic patients underwent open biopsy and only 26% (9/34) of symptomatic patients were observed clinically without biopsy. In symptomatic patients, open biopsy can be diagnostic and therapeutic, but less invasive procedures are preferred [16]. …”

Section: Discussionmentioning

confidence: 99%

Watchful waiting for some children with a mediastinal mass: the potential role for 18 F-fluorodeoxyglucose positron emission tomography: a case report and review of the literature

et al. 2013

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BackgroundBenign hyperplastic thymus is a rare but important differential diagnosis of anterior mediastinal lesions. Histological and radiological criteria are used to distinguish this benign condition from other malignant diseases but have their limitations, and biopsy of mediastinal masses can be risky. We report for the first time the diagnostic value of fluorodeoxyglucose 18 F positron emission tomography for patients with incidentally identified anterior mediastinal masses to avoid biopsy in some cases.Case presentationA 2 year old girl presented with new onset of emesis and constipation leading to the incidental discovery of an anterior mediastinal mass on radiograph. Chest computed tomography revealed cystic components within the mass concerning for a malignancy. Biopsy of the lesion and bone marrow aspiration and biopsy were negative but there was concern that the mediastinal biopsy may have missed the malignant component of the lesion. Hence, a positron emission tomography scan was obtained that showed mild homogeneous fluorodeoxyglucose 18 F avidity within the mass similar to that of normal thymus. The diagnosis of benign hyperplastic thymus was made.ConclusionThe differential diagnosis of an incidentally found anterior mediastinal mass includes malignancy, but benign lesions such as benign hyperplastic thymus must also be considered, particularly when the complete blood count and biochemical profile are normal. Fluorodeoxyglucose 18 F positron emission tomography can help guide a clinician’s decision for further interventions and treatment.

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Management of children and adolescents with a critical airway due to compression by an anterior mediastinal mass

Cited by 67 publications

References 27 publications

Tracheobronchomalacia in Infants and Children: Multidetector CT Evaluation

Tracheobronchomalacia in Infants and Children: Multidetector CT Evaluation

Palliative radiation therapy for superior vena cava syndrome in metastatic Wilms tumor using 10XFFF and 3D surface imaging to avoid anesthesia in a pediatric patient—a teaching case

Watchful waiting for some children with a mediastinal mass: the potential role for 18 F-fluorodeoxyglucose positron emission tomography: a case report and review of the literature

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