Mumbai, Jan 09: A two-year-old girl suffering from progressive breathing difficulty due to a rare and complex chest mass compressing her airway has been successfully treated after timely medical intervention.
The child had been experiencing neck swelling, stiffness, noisy breathing and changes in her voice for several months, with symptoms worsening during infections and while lying down.
Critical diagnosis at city hospital
The child was brought to Narayana Health SRCC Children’s Hospital, Mumbai, where clinical examination revealed tracheal deviation, raising concerns of a potentially life-threatening airway obstruction. Considering the child’s young age, even minimal airway compromise posed a serious risk.
Advanced imaging, including ultrasound and contrast-enhanced CT scans, identified a complex anterior mediastinal mass arising from the thymic region and extending into the neck, causing significant compression and displacement of the trachea.
Multidisciplinary surgical approach
A multidisciplinary paediatric team led by Dr. Rasikal Shah, Senior Consultant – Paediatric Surgery, along with Dr. Pradeep K. Kaushik, Senior Consultant – Paediatric Cardiac Surgery, planned and executed the surgical intervention.
Anaesthesia and airway management were handled by a specialised paediatric anaesthesia team led by Dr. Nandini Dave, Senior Consultant – Paediatric Anaesthesiology, due to the high risk associated with mediastinal masses in young children.
Change in surgical strategy
During surgery, intraoperative ultrasound revealed solid components within the mass, prompting an immediate change in surgical strategy. The team proceeded with a median sternotomy to ensure complete and safe excision of the tumour while protecting vital mediastinal structures. Histopathological examination confirmed the mass to be benign, with features of myxoma/myxolipoma.
Doctors underline key challenges
Commenting on the case, Dr. Rasikal Shah said, “Mediastinal masses in young children present significant surgical and airway challenges. This case required precise intraoperative decision-making and close coordination among multiple specialties to achieve a safe outcome.”
Dr. Pradeep Kaushik added, “Early identification of airway compromise and adaptability in surgical planning were key factors in the successful treatment of this child.”
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Smooth recovery
The surgery involved meticulous dissection to safeguard the trachea, thymus and major mediastinal vessels, with minimal blood loss. The child was closely monitored postoperatively, made a smooth recovery and was discharged in stable condition.
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