Abstract
A 28-year-old female had an abnormal shadow in the right mediastinum on a routine chest X-ray. We performed thoracoscopic surgery, and found a cystic tumor surrounding the SVC, azygos vein, and trachea. After aspiration of the contents, we tried total removal of the cyst, but only subtotal cystectomy was possible, because the cyst wall was densely adherent to the SVC and azygos vein. Three days after the operation the abnormal shadow on her chest X-ray reappeared, and slight fever continued. We performed reoperation with thoracotomy 14 days after the first operation, with total cystectomy and ligation of the lymphatic duct. Surgery for mediastinal lymphangioma requires adequate dissection so that the lymphatic duct can be ligated securely.
