PMC7550823_01
Pre operative view of the patient on the OR table.
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Upon examination, the swelling was present over the region extending from carotid sheath to mediastinum on the left side passing behind the sternum (Fig. 1).
MRI showing the extension of the lesion from the neck into the thoracic cavity.
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Magnetic resonance imaging (MRI) of the lesion showed a well-defined cystic lesion in the left upper anterior triangle of the neck deep to the sterno cleido mastoid muscle involving the carotid sheath and extending into mediastinum on the left side passing behind the sternum (Fig. 2).
Internal carotid artery and internal jugular vein after dissecting the lesion from the carotid sheath.
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When the lesion was found to be inseparable from the left side of the sternum total surgical excision of the lesion was planned together with the cardiothoracic team and open thoracotomy was done and the lesion was dissected from the mediastinum and the pleura up to the suprasternal notch (Fig. 3).
The excised hygroma measuring about 20 cm in length.
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Following excision, the cyst was measured to be 20 cm in length (Fig. 4). 6 months follow up with no recurrence evidence.