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Bilateral spontaneous chylothorax presenting as a neck mass.

Chylothorax is a relatively rare condition. Bilateral chylothorax is even more unusual with the majority resulting from trauma or in association with a neoplasm. We describe a case of bilateral spontaneous chylothorax which presented as a sudden neck mass in a 45 year old, healthy female. A complete evaluation failed to reveal any cause. Successful management included thoracentesis and a medium chain triglyceride diet. The patient remains well with a normal chest x-ray and CAT scan of the thorax and abdomen at one year. Spontaneous bilateral chylothorax presenting as a neck mass with no evidence of trauma or tumor has, to our knowledge, not previously been reported in the literature.