A patient was scheduled for upper esophagus tumor resection under general anesthesia. A large mass (14 × 2 × 2 cm) was found in the esophagus (panel A). The mass could be regurgitated freely to the mouth (panel B) and swallowed back into the esophagus. The patient denied significant difficulty breathing or swallowing. To achieve the surgical view with suspension laryngoscopy, the surgeon requested that the mass be kept in the mouth intraoperatively. Awake intubation was discussed because of a concern for airway compromise after induction but not performed due to patient refusal. Instead, tracheal intubation was performed after induction. To ensure the mass was swallowed into the esophagus during induction/intubation and pulled back into the mouth for surgery after intubation, the tip of the tumor was anchored with a suture after topicalization and before...

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