Abstract
The complete and safe removal of a mediastinal mass requires cardiopulmonary bypass if the mass encroaches or compresses the heart and its great vessels. A 15-year-old male presented with a huge mediastinal mass with gradually worsening symptoms. Surgical removal of the tumour was planned under general anaesthesia and cardiopulmonary bypass based upon contrast-enhanced computed tomography of the chest, which suggested infiltration of the cardiac structures. Intraoperative transoesophageal echocardiography revealed a distinct separation of the tumour mass from the heart and its great vessels. The mass was excised en bloc without cardiopulmonary bypass.