Hoarseness caused by mediastinal cystic hygroma has not been reported
before. The authors report a case of mediastinal cystic hygroma in whi
ch the patient's only symptom was hoarseness, A 6-year-old girl had ho
arseness. Physical examination findings were normal except for indirec
t laryngoscopy, which showed unilateral vocal cord paralysis. The ches
t radiograph showed an opacification 3 cm wide in the left side of the
superior mediastinum, Through a median stern otomy, a large multicyst
ic mass was resected. During resection, left laryngeal recurrent nerve
was seen to be intact, and its integrity was preserved. Six months la
ter the left vocal cord was moving to a limited extent. A chest radiog
raph should be considered in a case of hoarseness caused by a peripher
al nerve lesion to detect a mediastinal mass without any cervical comp
onent. Copyright (C) 1998 by W.B. Saunders Company.