A patient presented with fever and a mediastinal mass. Aortography revealed a small aneurysm within the mass. At thoracic surgery a mediastinal abscess with a ruptured aortic aneurysm was found. The resected part of the aorta was successfully replaced with a graft and the patient survived for ten days, finally succumbing from the grave infection but with a functioning graft. Multiple sections revealed a necrotic tumour with solid cancer cells from an undifferentiated carcinoma, explaining the pathogenesis of the mediastinitis as well as the lack of cure with antibiotic treatment.
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