Ventriculopleural shunt CSF pseudocyst presenting as an anterior mediastinal mass

A CSF pseudocyst is a well-recognised complication of CSF diversion catheters that is most commonly associated with ventriculoperitoneal shunts. 1 The ventriculopleural shunt is an alternative method of CSF diversion used when ventriculoperitoneal or ventriculoatrial shunts are not suitable due to adhesions, a history of peritonitis, ascites, peritoneal dialysis or failure of a prior ventriculoperitoneal shunt. 2 Although uncommon, the ventriculopleural shunt is associated with a number of complications in the chest, including pleural effusion, empyema, tension hydrothorax, pneumothorax and rarely, as in this case, a CSF pseudocyst. 2 An understanding of this alternative method of CSF diversion and awareness of the potential complications is essential when radiographic abnormalities of the chest are encountered in a patient with a ventriculopleural shunt.