Related Experiment Video
Updated: Jun 12, 2025
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Children With Airway Compressions Caused by Mediastinal Tumors: A Single-Center Case Series
Ryosuke Nakai1, Kazunori Aoki1, Taisuke Matsumoto2
1Pediatric Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, JPN.
Insights
Pediatric mediastinal tumors are often misdiagnosed as asthma, delaying critical treatment. Early chest radiography is crucial for diagnosing these tumors and preventing life-threatening airway obstruction in children.
Area of Science:
- Pediatric Oncology
- Thoracic Surgery
- Pediatric Pulmonology
Background:
- Mediastinal tumors in children can mimic symptoms of bronchial asthma.
- Misdiagnosis leads to delayed diagnosis, airway obstruction, and potential cardiac arrest.
Purpose of the Study:
- To identify key factors for the early diagnosis of pediatric mediastinal tumors.
- To prevent life-threatening airway obstruction and cardiac arrest in affected children.
Main Methods:
- Retrospective review of medical records of 14 pediatric patients.
- Analysis of patients with airway compression due to mediastinal tumors.
- Study period: April 2016 to September 2023 at Hyogo Prefectural Kobe Children's Hospital.
Main Results:
- Median age at diagnosis was 9.8 years; all had anterior mediastinal tumors.
- 42% of patients initially presented with respiratory symptoms but faced diagnostic delays exceeding one month.
- Six patients (42%) were initially treated for bronchial asthma; three experienced cardiac arrest before diagnosis.
Conclusions:
- Mediastinal tumors should be considered in the differential diagnosis for children with persistent, atypical respiratory symptoms suggestive of asthma.
- Prompt chest radiography is recommended for children with concerning respiratory symptoms to rule out mediastinal tumors.
Background:
Mediastinal tumors in children may be misdiagnosed as bronchial asthma, resulting in delayed diagnosis and airway obstruction leading to cardiac arrest.
Purpose:
This study aimed to identify factors for early diagnosis of mediastinal tumors in children to avoid a life-threatening situation.
Methods:
We retrospectively reviewed the medical records of 14 children with airway compressions caused by mediastinal tumors who visited the Hyogo Prefectural Kobe Children's Hospital between April 2016 and September 2023.
Results:
The median age at diagnosis was 9.8 years; all patients had anterior mediastinal tumors. Respiratory symptoms included cough in seven cases, orthopnea in five cases, wheezing in four cases, tachypnea in one case, and no symptoms in one case. Although six patients (42%) visited medical institutions presenting with respiratory symptoms, more than a month passed before diagnosis. Six patients (42%) received bronchial asthma treatment. Most cases (n=9, 64%) were diagnosed using chest radiography; two cases were diagnosed using computed tomography. Three patients experienced cardiac arrest because of airway obstruction before mediastinal tumor diagnosis. Chest radiography on admission showed abnormal mediastinal shadows in all cases.
Conclusion:
In children with prolonged respiratory symptoms and an atypical course of bronchial asthma, mediastinal tumors should be considered as a differential diagnosis, and chest radiography should be performed.
Related Concept Videos
01:27Pneumothorax-II
Clinical Manifestations:
01:17Pulmonary Cycle: Exhalation
01:22Trachea
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of...
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:26Pneumothorax-I
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.