# Children With Airway Compressions Caused by Mediastinal Tumors: A Single-Center Case Series

## TL;DR

This study examines 14 children with mediastinal tumors causing airway compression, highlighting the importance of early diagnosis to prevent life-threatening complications.

## Contribution

The study identifies clinical features and diagnostic delays in children with mediastinal tumors misdiagnosed as asthma.

## Key findings

- Most cases (64%) were diagnosed using chest radiography, with abnormal mediastinal shadows observed in all cases.
- Three patients experienced cardiac arrest due to airway obstruction before diagnosis.
- Over 40% of patients received bronchial asthma treatment before correct diagnosis.

## Abstract

Background: Mediastinal tumors in children may be misdiagnosed as bronchial asthma, resulting in delayed diagnosis and airway obstruction leading to cardiac arrest.

Purpose: This study aimed to identify factors for early diagnosis of mediastinal tumors in children to avoid a life-threatening situation.

Methods: We retrospectively reviewed the medical records of 14 children with airway compressions caused by mediastinal tumors who visited the Hyogo Prefectural Kobe Children’s Hospital between April 2016 and September 2023.

Results: The median age at diagnosis was 9.8 years; all patients had anterior mediastinal tumors. Respiratory symptoms included cough in seven cases, orthopnea in five cases, wheezing in four cases, tachypnea in one case, and no symptoms in one case. Although six patients (42%) visited medical institutions presenting with respiratory symptoms, more than a month passed before diagnosis. Six patients (42%) received bronchial asthma treatment. Most cases (n=9, 64%) were diagnosed using chest radiography; two cases were diagnosed using computed tomography. Three patients experienced cardiac arrest because of airway obstruction before mediastinal tumor diagnosis. Chest radiography on admission showed abnormal mediastinal shadows in all cases.

Conclusion: In children with prolonged respiratory symptoms and an atypical course of bronchial asthma, mediastinal tumors should be considered as a differential diagnosis, and chest radiography should be performed.