ABSTRACT
Mediastinal masses in the newborn represent a wide variety of congenital and neoplastic lesions, which can present interesting diagnostic and therapeutic challenges. Posterior mediastinal lesions include the tumors of neurogenic origin, undifferentiated sarcomas, congenital foregut duplications, and extralobar sequestrations. The goals of diagnostic imaging evaluating a mediastinal mass include: identifying the characteristics and origin of the mass within the mediastinum; delineating the extension; and providing a differential diagnosis. Skin testing and complement fixation titers should be considered in infants with middle mediastinal masses to rule out granulomatous infections. The anterior mediastinum is usually not difficult as there is frequently a characteristic "sail" sign on routine chest x-ray. Lymphomas are the most frequent tumors involving the middle mediastinum over 2 years of age but are rarely seen in the newborn or infant. The most important factor in preventing anesthetic complications in children with mediastinal mass is a recognition of the aforementioned problems and the anticipation of a possible airway problem.
