A 22-year-old male with a giant anterior mediastinal mass underwent general anesthesiaand tumor removal through Clamshell incision. The mass (approximately 4 kg) that occupiedthe plural cavity with retarded venous drainage of the chest caused the symptoms and signs ofSVC obstruction. Due to no sign of upper thoracic airway obstruction, the operation plan wasnot included CPB standby. Anesthesia in this case was difficult from the beginning. However,it was smoothed out with subsequent intravenous thiopental induction, followed by atracuriumand sevoflurane in maintenance of the anesthesia. During the operation, accidental tear of theright atrium occurred; controls of the cardiovascular stability were subsequently critical. Inspite of this, the patient was finally saved and had rapid recovery after surgery. Postoperativepathological examination including microscopic examination revealed only benign componentof germ cells viable in the specimen. All margins were free from the tumor. The patient wasdischarged 5 days after the operation.
Faculty of Medicine, Chulalongkorn University
Sindhvananda, W and Luengtaviboon, K.
"Surgical and anesthetic managements of an adultpatient with a giant mediastinal mass,"
Chulalongkorn Medical Journal: Vol. 56:
1, Article 6.
Available at: https://digital.car.chula.ac.th/clmjournal/vol56/iss1/6