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Anesthetic Management of a Pregnant Patient With a Large Anterior Mediastinal Mass Undergoing Diagnostic

Rei Ndoni1, Aariya Srinivasan1, Ryan Dougherty1

  • 1Department of Anesthesiology Research, Cleveland Clinic Foundation, Cleveland, Ohio, USA, clevelandclinic.org.

Case Reports in Anesthesiology
|October 27, 2025
PubMed

This case report details the successful use of awake fiberoptic intubation in a 28-year-old pregnant patient at 21 weeks gestation, who presented for diagnostic mediastinoscopy with biopsy secondary to a large anterior mediastinal mass suspected to be lymphoma. MRI displayed encasement of the superior mediastinal vasculature and 13.0 cm × 7.6 cm coalescence in the anterior mediastinum. Given the size of the mass and potential for airway and vascular complications, awake fiberoptic intubation was chosen to ensure safety for both mother and fetus. The case underscores the efficacy of awake fiberoptic intubation in complex airway management scenarios in pregnant patients, highlighting the importance of a multidisciplinary approach to optimize patient care and outcomes.

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