Presentation
Chest pain and difficulty breathing.
Patient Data
Large anterior mediastinal mass, best appreciated on the lateral view. On the frontal view it gives the illusion of cardiomegaly.
Lungs are clear with no evidence of pulmonary congestion.
There is a large, multiloculated, non-enhancing cystic mass of fluid-attenuation centered on the anterior mediastinum, asymmetric to the left side. It causes displacement of the adjacent airways and vascular structures without evidence of compression.
No other significant findings are appreciated.
Unremarkable chest radiograph with no evidence of recurrence on 8 years follow-up study.
Case Discussion
This is a case of histologically-confirmed mediastinal lymphatic malformation.
Patient first presented with chest pain and difficulty breathing, and a mediastinal mass was detected on chest radiograph and CT. After that, the patient underwent a draining procedure and had a Chamberlain procedure to biopsy the wall, which was positive for lymphatic malformation. However, the cyst kept recurring despite multiple draining and sclerotherapy procedures with doxycycline and the patient continued to be symptomatic. Because of that, the decision was made to excise the lesion thoracoscopically. The procedure was successful, and most of the cyst was removed and the patient has had no recurrence on 8 years follow-up chest radiograph.