Cystic hygroma is a benign congenital lymphatic malformation affecting mainly the head and neck region in children. Although mediastinal or multiorgan lymphangiomatosis is rare, it can present at any age. We report an unusual case of recurrent bilateral cystic hygroma in an adult affecting both neck and mediastinum. When the extensive lesion became symptomatic, a multidisciplinary approach was necessary to remove the expanding mass to achieve the optimal functional and cosmetic outcome.