Giant pericardial cyst mimicking dextrocardia on chest X-ray

Abstract

Pericardial cysts are rare benign congenital malformations, usually small, asymptomatic and detected incidentally on chest X-ray as a mass located in the right costophrenic angle. Giant pericardial cysts are very uncommon and produce symptoms by compressing adjacent structures. In this report, the authors present a case of a symptomatic giant pericardial cyst incorrectly diagnosed as dextrocardia on chest X-ray. © 2012 Sociedade Portuguesa de Cardiologia Published by Elsevier España, S.L. All rights reserved. PALAVRAS-CHAVE Quisto pericárdico; Telerradiografia de tórax Quisto pericárdico gigante a imitar dextrocardia na telerradiografia de tóraxResumo Os quistos pericárdicos são malformações congênitas benignas raras. Habitualmente. são de pequena dimensão, assintomáticos e detectados de forma acidental na telerradiografia de tórax, como uma massa localizada no ângulo costofrênico direito. Grandes quistos pericárdi-cos são ainda mais raros e produzem sintomas por compressão de estruturas adjacentes. Neste artigo, os autores apresentam um caso clínico de um quisto pericárdico gigante e sintomático previamente diagnosticado como uma dextrocardia em telerradiografia de tórax. © 2012 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L. Todos os direitos reservados. Case reportA 30-year-old man reported dysphagia and weight loss (15 kg) during the previous four months. Palpitations and * Corresponding author.E-mail address: hamadmahmoud77@hotmail.com (H.M. Hamad).chest pain unrelated to physical or emotional stress began two months later. A routine annual visit to the occupational medicine clinic revealed normal physical examination and laboratory tests. The chest X-ray ( Figure 1A) suggested a diagnosis of dextrocardia that was not observed on previous annual chest X-rays, and the ECG ( Figure 1B) was normal. Outpatient echocardiography was also normal. The patient was referred to the cardiology department for further investigation.

A large pericardial cyst mimicking a unilateral pleural effusion: A case report

“…Furthermore, when the lesion is extensive and involves mediastinal and thoracic structures, the atypical presentation further complicates the diagnosis. [ 8 ] In this case, this symptomatic giant pericardial cyst was initially incorrectly diagnosed as encapsulated pleural effusion in the left chest due to the lesion appearing to be in contact with the pleura and left lower lung. The nonspecific fluid density of the cyst also posed a diagnostic challenge in distinguishing it from loculated effusion on imaging.…”

“…[ 5 , 12 ] However, each imaging modality has its own limitations, and histological examination is warranted to obtain a consolidated diagnosis and established a definite diagnosis. [ 8 ]…”

“…[5,12] However, each imaging modality has its own limitations, and histological examination is warranted to obtain a consolidated diagnosis and established a definite diagnosis. [8] The need for changes in management depends on the patients' symptoms and complications and the size and location of the cyst. [13] In most patients, close follow-up with serial transthoracic echocardiography is sufficient for monitoring and to ensure a benign course in which the pericardial cyst can resolve spontaneously.…”

Quiste pericárdico gigante asintomático

“…Los pacientes con quistes pericárdicos son asintomáticos en la mayoría de los casos (50-75%); sin embargo, dentro de los reportes de quistes pericárdicos gigantes, con diámetros desde 6.5 × 9 cm hasta 21.5 × 11.4 × 14.2 cm, solo dos pacientes se encontraban asintomáticos (Tabla 1) 1,[5][6][7][8][9][10][11][12][13][14][15][16] .…”

Image Diagnosis: Pericardial Cyst in a Dialysis Patient

“…The discovery of a pericardial cyst obliges the clinician to perform a broad differential diagnosis with a coronary artery aneurysm, dextrocardia, malignancy, and even pneumonia. 5) CMR may help in this diagnosis.…”