Asymptomatic undetected mediastinal mass: a death during ambulatory anesthesia

T-cell lymphoma is the fastest growing non-Hodgkin's lymphoma occurring in children. Its clinical presentation is frequently abrupt, and total tumor mass can double every few days. At the same time, the number of ambulatory anesthesia procedures for children is increasing at a rapid rate. Anesthesiologists are constantly faced with decisions regarding the adequacy of available preoperative information. What information do we need, and how recent should it be? This case shows that recent diagnostic imaging studies not showing the presence of a mediastinal lymphoma can be misleading. It provides a strong warning to all anesthesiogists involved in ambulatory anesthesia.