A 57-year old woman presented with intermittent swallowing discomfort for 3 months. A computed tomography (CT) angiography showed a mediastinal bronchial arterial aneurysm, a widening of the bronchial artery tortuously, a right hilar mass and anomalous communication between the bronchial and pulmonary arteries (Fig. 1A–D). The patient declined all invasive procedures although we recommended interventional treatment.