Etiology and outcome of prenatally detected paracardial cystic lesions: a case series and review of the literature

Abstract

Fetal echocardiography enables early detection of paracardial cyst. Pericardial cysts disappeared spontaneously during the course of gestation without signs of fetal cardiac compromise, suggesting a benign prognosis. Imaging by magnetic resonance and computerized tomography were particularly useful to clarify the etiology, structure and extent of those cysts that had not resolved by the time of birth. Published by John Wiley & Sons, Ltd.

Anterior Mediastinal Lymphangioma in an Infant: Diagnosis and Surgical Management

“…Lymphangiomas can be detected antenatally, appearing as a cystic mass that may enlarge on follow-up [4,5]. A mediastinal mass was identified in our patient at 20 weeks gestation which regressed and was not demonstrated by late antenatal or early postnatal ultrasounds.…”

“…A mediastinal mass was identified in our patient at 20 weeks gestation which regressed and was not demonstrated by late antenatal or early postnatal ultrasounds. Although the most likely diagnosis at the time of initial antenatal ultrasound was teratoma, this was revised as spontaneous regression of fetal intra-thoracic tumours is most commonly seen with simple pericardial cysts [4,5]. Thus, in our asymptomatic patient the most appropriate course of action appeared to be close follow-up, with planned cardiac magnetic resonance imaging within the first six months of life.…”

Isolated Mediastinal Lymphangioma: Prenatal Diagnosis and Thoracoscopic Treatment

“…Th ey constitute about 3% of all mediastinal masses in children [2]. A pre natal diagnosis has already been reporte d in 8 cases for a n i solated ML [3][4][5][6][7][8][9][10]. It m ay be s uspected when t he sonographic examination shows a si ngle or multilocated paracardiac an terior m ediastinal cystic mass.…”

“…In our case, a fetal MRI was also performed and showed the e xact location of t he lesion an d its ex tension. As th e i ntracystic sep tations are n ot alw ays v isible on fetal u ltrasonography, other diagnoses ha ve t o b e proposed: pericardial cy st, bronchogenic cyst, thymic cyst, teratom a, esophage al duplication a nd ne urenteric cyst [8,12,13]. A p oor outcome i s pos sible with fetal hy drops a nd hy poplastic lungs, and prenatal thoracocentese may be discussed [3].…”

“…The l ast 3 M L were respected and overseen after birth, but the ML increased , as in our case, and a thoracot omy was decided at 6 wee ks of life for 2 and 19 months for one. Usually, thoracotomy or median sternotomy are perform ed, but the t horacoscopic treatment of s uch lesion is now possible [13,20]; this procedure has bee n shown t o be s afe i n a s eries o f 22 m ediastinal cysts in ch ildren, one of which being a ML [13 ], and in 2 other cases at 19 months and 7 years old [8,16]. Our c hild was 7 m onths o ld w hen t he t horacoscopic treatment was pe rformed.…”