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Abstract Background Lymphangioma of the mediastinum is a rare benign tumor, and most of the cases are treated by a surgical approach. Case presentation This work reports the case of a 62-year-old female with a large lymphangioma extending from her neck to her abdomen with dysphagia, dyspnea, and cough for 2 months. Because of the location of the mass, only bilateral excision could remove the multiloculated cyst completely. However, the patient’s overall physical condition was very poor, and we thought she could not tolerate the bilateral surgery. Therefore, the patient was treated by percutaneous aspiration drainage followed by fibrin glue injection. Our method has never been reported in the treatment of such a large intrathoracic lesion thus far. Conclusions Percutaneous puncture and aspiration drainage followed by fibrin glue injection may be a feasible treatment option for the therapy of intrathoracic lymphangioma, with less damage than with other therapies.