Multicystic Alveolar Adenoma in a Symptomatic Adult with Extensive Bullae and Mediastinal Shift

We present a unique case of alveolar adenoma with extensive bullous disease in a young female patient that presented as left sided pleuritic chest pain and shortness of breath. The patient had a pneumothorax and mediastinal shift. She underwent upper lobectomy that resulted in relative a resolution of the mediastinal shift. We discuss the unique clinical and pathologic presentation of this rare benign neoplasm in this patient.