Sudden Cardiac Arrest in a Child with an Unrecognized Superior Mediastinal Tumor

A 4-year-old boy suffered a sudden cardiac arrest caused by an unrecognized mediastinal tumor when he was placed in the supine position by force for a venipuncture. Permanent neurological dysfunction resulted even after vigorous resuscitation. A mediastinal mass was seen on the chest film. It is believed that forcing the child into the supine position triggered compression of the cardiopulmonary system by the mass. This present case is to remind physicians to be alert for mediastinal tumors in children, particularly for patients with unusual symptoms and signs or refractory response to treatment.