Radiation therapy allows patients to receive focused radiation to a tumor. Some patients require anesthesia for their daily treatments. For head and neck tumors, a thermoplastic mask is created to minimize movement. We describe a case where a patient's neck circumference increased during the course of treatment. Given that the patient was under anesthesia for each treatment, he was not able to relay the tightness of the mask. This led to cerebral hypoxia. Cerebral oximetry confirmed this diagnosis, and the patient's mask was refitted-remaining anesthetics were uneventful. Mask fitness should be reassessed during the treatment series.
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