Pericardial Cyst, A Rare Incidental Finding in an Uncommon Location: A Case Report

Abstract

A pericardial cyst is one of the rare causes of mediastinal masses. Most of the cases are secondary to congenital incomplete fusion of the pericardial sac. More than two-thirds of the cases are present in the right cardiophrenic angle, and the left cardiophrenic angle is the second most common location. In our study, we illustrated an incidental finding of the pericardial cyst in a patient who presented with nonspecific symptoms and was found to have a left-sided cardiophrenic pericardial cyst, which is only found in about 20% of the cases. A CT scan and echocardiogram confirmed the diagnosis of a 4.39-centimeter cyst with no signs of complications like tamponade or pericarditis. As the patient's symptoms resolved, outpatient follow-up with serial echocardiogram was advised. Through this report, we aim to raise awareness of the importance of further investigation for nonspecific symptoms like atypical chest tightness and differentiating simple pericardial cysts from other pericardial lesions. Based on the symptoms, size, and compression effect of the cyst, management may vary from serial echocardiogram to aspiration or surgical resection.

Successful Sternotomy to Remove an Enlarging Symptomatic Pericardial Cyst

“…Surgery is recommended in symptomatic patients, large cysts, and radiologic features of compression or potential for malignancy. Videoassisted thoracoscopic surgery (VATS) is the preferred approach [6]. VATS is associated with less blood loss and decreased length of stay.…”

“…Other approaches include mediastinoscopy, sternotomy, and thoracotomy. If conservative measures are desired, imaged-guided aspiration is also a possibility with a 33% risk of recurrence [6].…”

Giant pericardial cyst, an unusual cause of right heart failure in an elderly patient with tuberculosis and HIV: A case report

“…[2] making it difficult to diagnose. CT scans are excellent for differentiating pericardial cysts from other mediastinal masses [9] . The cysts appear as well-defined thin-walled, well-demarcated oval homogenous masses which fail to enhance postcontrast administration [ 4 , 10 ] as was the case of the pericardial cyst of the patient.…”

Large Pericardial Cyst Mimicking Recurrent Unilateral Pleural Effusion on CT Scan: A Case Report and Literature Review

“…PCs are uncommon intrathoracic structures typically discovered incidentally. They often arise from incomplete fusion during embryogenesis, resulting in herniation or weakness in the pericardial sac and diverticulum formation [2,3]. The relationship between the pericardial diverticulum and cyst, originating from the same embryonic source, was first recognized by Rohn A in 1903 [3].…”

“…They often arise from incomplete fusion during embryogenesis, resulting in herniation or weakness in the pericardial sac and diverticulum formation [2,3]. The relationship between the pericardial diverticulum and cyst, originating from the same embryonic source, was first recognized by Rohn A in 1903 [3]. It can also develop as acquired conditions secondary to pericarditis, inflammatory disorders, or previous surgeries.…”