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BACKGROUND: Multilocular thymic cysts (MTCs) in adults with human immunodeficiency virus (HIV) are rarely reported. CASE PRESENTATION: We describe a case of symptomatic MTC in a male with untreated HIV. A presumptive diagnosis was established based on radiographic imaging and biopsy. Pathologic diagnosis and exclusion of malignancy were ultimately confirmed following thymectomy. In conjunction with starting antiretroviral therapy, the patient recovered well post-operatively with a resolution of his presenting symptoms. CONCLUSION: Our case report and review of the literature serve to highlight MTCs as an important clinical entity occurring in persons with HIV.
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