LAUSR

Although anterior mediastinal masses (AMM) are relatively rare in children, they are a common source of anxiety among pediatric anesthesiologists. Typically, the diagnosis is made from an initial chest radiograph (CXR) that immediately gets the attention of the emergency physicians, oncologists, surgeons, and anesthesiologists. Because these tumors occupy the same space as major pulmonary and cardiovascular structures, the potential for life-threatening anesthetic complications is extremely high. The anesthetic management has evolved over time; a multidisciplinary approach to diagnosis and management offers the safest course for these vulnerable patients. Case reports documenting the hazards of general anesthesia and AMM go back decades, with several reports associated with mortality. More recent series at major institutions where there is awareness of the tenuous nature of this population are associated with fewer anesthetic complications. However, there are still reports of undiagnosed or untreated AMM resulting in mortality. The goals of management in this population are 2-fold, and may be at odds. There is a need for an accurate tissue diagnosis to ensure correct