Abstract
The presentation of the bronchogenic cyst is variable, making pre-operative diagnosis difficult. Majority of them are either asymptomatic or discovered incidentally. The most common presenting symptoms are cough, fever and dyspnea. We discuss the case of a large bronchogenic cyst in the posterior mediastinum causing oesophageal compression and impinging on the left atrium. The patient presented with dysphagia and back pain and was extensively investigated by various physicians before being diagnosed as having bronchogenic cyst. We concluded that the backache was due to stretching of nerves in the parietal pleura. This case demonstrates the need for detailed investigations prior to treatment of patients with such symptom complex as a bronchogenic cyst may be the cause of such symptoms.