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.