Hemomediastinum and bilateral hemothorax with extensive angiomatosis of anterior mediastinum

Angiomatosis is a rare, benign but clinically extensive and serious vascular lesion of soft tissue. Hereby, we report a case of diffuse angiomatosis of mediastinum, presenting with hemomediastinum and bilateral massive hemothorax in a 19-year old boy. On medical imaging, mediastinal widening along with enhanced small vessels and capillaries were detected. On operation, hemorrhagic sponge-like vascular tissue patches were seen extensively in pericardium, pleura, lymph node and thymus as well. The lesion was debulked. The pathologic evaluation revealed characteristic features of soft tissue angiomatosis involving thymus, lymph node, pleura, pericardium and its fibrofatty tissue. Diffuse angiomatosis should be considered for differential diagnosis of vascular lesions of anterior mediastinum.