Critical airway compression caused by a large mediastinal tumour with spontaneous haemorrhage

We report the case of a 77-year-old woman presenting with out-of-hospital cardiac arrest, which was then interpreted as an acute, life-threatening critical airway compression by a huge mediastinal tumour without appropriate diagnosis. Emergency extracorporeal membrane oxygenation was cannulated for sufficient respiratory support after spontaneous circulation was regained. After the multidisciplinary team, involving thoracic surgeons, discussed the resectability of the mediastinal tumour, the patient underwent successful resection of the mediastinal tumour through a median sternotomy. The pathological report demonstrated an intrathoracic goitre with spontaneous haemorrhage and haematoma formation, and the patient was discharged with favourable respiratory and neurological outcomes.