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Mediastinal mass syndrome represents a major threat to respiratory and cardiovascular integrity, with difficult evidence-based risk stratification for interdisciplinary management. We conducted a narrative review concerning risk stratification and difficult airway management of patients presenting with a large mediastinal mass. This is supplemented by a case report illustrating our individual approach for a patient presenting with a subtotal tracheal stenosis due to a large cyst of the thyroid gland.

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Pericardial cysts are a rare and benign entity that comprise 7% of the mediastinal masses. They are asymptomatic in over half of the cases, being usually detected as an incidental mass lesion on chest X-ray. When symptomatic, they usually present with dyspnea, chest pain, or persistent cough.

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