Our case report describes an unusual cause of a mediastinal mass. The patient is a current smoker with a background of neurofibromatosis (NF) type 1 who presented with a right apical mass. Initial investigations suggested a probable malignant cause. The final diagnosis was one of a haematoma from a ruptured thyrocervical aneurysm. The association between neurofibromatosis and vascular aneurysms is an often unrecognised but documented phenomenon. We would like to raise an awareness of this infrequent presentation, as it is associated with a high mortality and may be prevented by early diagnosis.
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