The frontal chest x-ray shows superior mediastinal mass encircling the trachea, causing deviation of the trachea to the right. A CT scan of the chest revealed a massive retrosternal goitre.
Procedural sedation for any reason in the emergency department carries significant risk in the above patient and as such should be avoided.
Differentials for an anterosuperior mediastinal mass are:
5 T’s (Radiopaedia) –
- Terrible lymphoma
- Thoracic aorta