Successful surgical management of capillary hemangioma of the anterior mediastinum with recurrent pleural effusion

We report a case of a 73-year-old male, presenting with persistent cough and shortness of breath. He was diagnosed with an anterior mediastinal mass with significant recurrent loculated pleural effusion. The pre-operative biopsy from the mass was inconclusive. The patient underwent video-assisted thoracoscopic decortication on the left side followed by anterolateral thoracotomy for radical mediastinal mass excision, with notable challenges including mass being densely adherent to critical mediastinal structures intra-operatively and atrial fibrillation postoperatively. Final histopathology was suggestive of "capillary hemangioma." This case highlights the complexity of diagnosing and managing such rare mediastinal mass and the importance of a multidisciplinary approach.