Mediastinal lymphangioma in an adult with a tracheal bronchus

Introduction Lymphangiomas, also known as cystic hygromas or cystic lymphangiomas, are cystic abnormalities of the lymph vessels and they are rare benign tumors. Tracheal bronchus (Bronchus suis or “pig bronchus”) is a very rare congenital anomaly. The aim of this work is to present а very rare case of а lymphangioma with tracheal bronchus. Case outline The article presents the rare case of a 35-year-old otherwise healthy man, who was admitted to our thoracic surgery department with a mediastinal tumor. On performing bronchoscopy a tracheal bronchus was found. A thoracic CT scan revealed a well-circumscribed mass in the superior and anterior mediastinum measuring 37 x 39 x 59 mm. First a Carlens mediastinoscopy, and then a right parasternal Chamberlain mediastinotomy were performed. The final pathological diagnosis of lymphangioma was made. In this case, surgery was not performed because the patient was asymptomatic and the tumor did not grow larger during follow-up. Conclusion The lymphangioma of the mediastinum in an adult is a rare and benign condition with a good prognosis, but it should be considered in a differential diagnosis of mediastinal tumors. We recommend only a minimally invasive diagnostic approach (parasternal mediastinotomy) when the patient is asymptomatic.