Mediastinal lymphangioma and chylothorax: the role of radiotherapy

An 11-year-old boy with a capillary/cystic lymphangioma of the posterior mediastinum is described, in whom a symptomatic chylothorax proved to be refractory to surgical management. The addition of low dose mediastinal radiotherapy (2,000 cGy/10 fractions) resulted in prompt and permanent resolution of the chylothorax. Although operation is the primary modality of treatment for these lesions, the addition of radiotherapy in such refractory patients appears to be well tolerated and efficacious and should result in few long-term complications.