Primary mediastinal embryonal cell carcinomas are aggressive tumors commonly presenting between the ages of 20-50 years with pulmonary symptoms (e.g., cough, chest pain, and hemoptysis), as well as extrapulmonary symptoms due to pressure on adjacent structures. Here we describe a 72-year-old man who remained undiagnosed for a prolonged period of time because of intractable epigastric pain. The patient was thought to have chronic pancreatitis for several months until a chest computed tomography scan demonstrated the mass. This case exemplifies that embryonal cell carcinoma may present in older age groups. It also illustrates the importance of including mediastinal tumors in the differential diagnosis of chronic epigastric pain and the need for further investigations to identify these tumors.