Pericardial Cyst: Case Reports and a Literature Review

Abstract

Pericardial cysts are rare mediastinal abnormalities, which are usually congenital but may also be acquired after cardiothoracic surgery. Cysts frequently occur in the right cardiophrenic angle and their diagnosis is usually suspected after an abnormal chest X ray is obtained. The presence of a pericardial cyst in this typical location or, less frequently, in an unusual location, poses a diagnostic challenge in distinguishing it from other intracardiac or mediastinal abnormalities. Two-dimensional echocardiography and transesophageal echocardiography are extremely valuable in diagnosing the presence of a pericardial cyst. Although most pericardial cysts are asymptomatic, patients may present with chest pain and dyspnea. In addition, life-threatening complications such as pericardial tamponade have been reported in association with pericardial cysts. The following cases illustrate the usefulness of two-dimensional echocardiography in making an accurate diagnosis of a pericardial cyst, as well as in follow-up of these patients for the development of possible complications.

Grande cisto pericárdico manifestando-se com compressão das câmaras cardíacas direitas

“…Among the complications include rupture, cardiac tamponade, obstruction of right main bronchus, obstruction of the outflow tract of the right ventricle and acute heart failure [11].…”

Tratamento cirúrgico de teratoma intrapericárdico em lactente

“…al. [7] considered that the best noninvasive diagnostic method is the echocardiogram, because it distinguishes the lesion from vascular structures, shows the relation among structures, and follows the cyst's growth. Every diagnosis performed in our case was shown through echocardiography, which plays an important role in the cardiac tumor evaluation and its intracardiac relations [8].…”

Posttraumatic pericardial cyst

“…The congenital encapsulated cysts arise from the pericardium in the early embryological development. Histologically these cyst are lined with a single layer of mesothelial cells that contains clear water-like fluid (so called usually as "spring water cyst") 5,6 . They do not frequently communicate with the pericardial cavity in the 80% of cases 7 .…”