Superior Mediastinal Syndrome Misdiagnosed as Foreign Body Aspiration: A Case Report.

Superior mediastinal syndrome is a life-threatening pediatric oncological emergency that requires high level of awareness and clinical suspicion to avoid misdiagnosis and devastating outcomes. Early diagnostic evaluation and management of underlying etiology are of utmost significance for optimal results. In children, it is most commonly caused by non-Hodgkin's lymphoma and T-cell lymphoblastic leukemia. We report a case of a six-year-old boy with superior mediastinal syndrome secondary to T-cell acute lymphoblastic leukemia, initially misdiagnosed as foreign body aspiration and underwent a procedure with a life-threatening outcome.

Superior Herniation of Normal Mediastinal Thymus.

Superior herniation of normal mediastinal thymus is a rare cause of anterior neck swelling, and only a few cases are reported in the literature. It clinically presents as a suprasternal swelling in the neck that appears during increased intrathoracic pressure. It is a benign condition that requires clinical and radiological awareness to avoid unnecessary investigations and invasive procedures. Ultrasound is the imaging of choice for the diagnosis, and management is conservative. This is a case report of a three-week-old male neonate who presented with anterior neck swelling and stridor, diagnosed as a case of superior herniation of normal thymus and was managed conservatively.

Congenital Vallecular Cyst: ARare and Potentially Lethal Condition.

Congenital vallecular cyst is a rare laryngeal lesion, accounting for 10-20% of all laryngeal cysts, with a potential to cause severe upper airway obstruction, which can be fatal. It can cause stridor, apnea, cyanosis, respiratory distress, and feeding difficulties. Diagnosis requires a high level of clinical suspicion and helps in timely intervention. Direct laryngoscopy is gold standard for definitive diagnosis. Treatment options include aspiration, marsupialization, and surgical excision. Here, we report a case of 7-week-old infant with complain of recurrent episodes of cyanosis when agitated, since the age of 3 weeks, admitted with impression of apparent life-threatening events (ALTEs). Extensive investigations were non-conclusive, which were done in local hospital. Direct laryngoscopy was performed in our hospital and showed presence of a vallecular cyst. Thus complete excision of cyst was done in the same setting with dramatic relief of symptoms.