Abstract:Pericardial cysts account for 12-18% of all mediastinal masses. They are usually asymptomatic and incidentally detected. However, when large, they can cause symptoms. Most pericardial cysts are located in the right cardiophrenic angle, but they can be anywhere in the mediastinum. We reported a pleuropericardial cyst torsion after physical stress, a very rare complication of this condition. The diagnosis was made by computed tomography and confirmed by video-assisted thoracoscopy.
“…As far as gender is concerned, the female: male ratio varies among many studies and it has been described to be 1:1 22 , 8:4 26 and 2:3 8 . Finally, PPCs can be associated with other diseases such as Fanconi anaemia 27,28 .…”
Section: Discussionmentioning
confidence: 99%
“…In postero-anterior projection, PPCs usually appear as rounded or oval opaque shadows with uniform density and well-defined borders and without calcification 77 . PPCs can also take on different and unusual radiologic appearances, such as a dumbbell shape 20,28,81 .…”
“…Moreover, MDCT can show stalks connecting PPCs to the pericardium, thus a certain diagnosis can be established even for PPCs in unusual locations 48,[87][88][89][90][91][92][93] . PPC torsion can also get depicted via a CT scan as a mass of soft tissue in which there is an internal intertwine with fat and soft tissue attenuation, called the ''whirl sign'' which was first described in intestinal volvulus 28,94,95 .…”
Background: Pleuropericardial cysts (PPCs), account for 5 -10% of all mediastinal tumours, are rare lesions occurring in approximately 1 in 100000 persons and are usually congenital and rarely acquired. They are detected postmortem or incidentally on routine chest X-ray (CXR) and in most cases multi detector Computer Tomography is used to confirm the diagnosis. As benign course and clinical latency are characteristic features of such cysts and the occurrence of complications is rare, the majority of them can be left untreated.
Methods:The aim of the study is to review the literature regarding PPCs and create a table which summarises all the published cases in order to draw a conclusion about the epidemiology, as well as the diagnostic and therapeutic approach to PPCs exclusively. We reviewed retrospectively the clinical manifestation, diagnostic and therapeutic approach in 101 cases of PPCs since the 19 th century Results: Our statistical analysis led to the following results: mean age of initial detection: 48.7 ± 17.2 years, female:male ratio: about 3:2, presence of symptomatology: 37/101 cases, most common location: right cardiophrenic angle (RCPA), most common method of initial detection: CXR in 49/101 cases, mean maximal diameter: 8,3 ± 3 cm.
Conclusion:The management of a pleuropericardial cyst should be based on an algorithm in which the cyst's size, shape and compressibility along with clinical presentation and patient's fitness and preferences are be taken into consideration. When interventional is required, surgical resection by means of traditional open surgery or minimally invasive methods are considered to be the gold standard and along with percutaneous aspiration are the methods that have mostly been used.
“…As far as gender is concerned, the female: male ratio varies among many studies and it has been described to be 1:1 22 , 8:4 26 and 2:3 8 . Finally, PPCs can be associated with other diseases such as Fanconi anaemia 27,28 .…”
Section: Discussionmentioning
confidence: 99%
“…In postero-anterior projection, PPCs usually appear as rounded or oval opaque shadows with uniform density and well-defined borders and without calcification 77 . PPCs can also take on different and unusual radiologic appearances, such as a dumbbell shape 20,28,81 .…”
“…Moreover, MDCT can show stalks connecting PPCs to the pericardium, thus a certain diagnosis can be established even for PPCs in unusual locations 48,[87][88][89][90][91][92][93] . PPC torsion can also get depicted via a CT scan as a mass of soft tissue in which there is an internal intertwine with fat and soft tissue attenuation, called the ''whirl sign'' which was first described in intestinal volvulus 28,94,95 .…”
Background: Pleuropericardial cysts (PPCs), account for 5 -10% of all mediastinal tumours, are rare lesions occurring in approximately 1 in 100000 persons and are usually congenital and rarely acquired. They are detected postmortem or incidentally on routine chest X-ray (CXR) and in most cases multi detector Computer Tomography is used to confirm the diagnosis. As benign course and clinical latency are characteristic features of such cysts and the occurrence of complications is rare, the majority of them can be left untreated.
Methods:The aim of the study is to review the literature regarding PPCs and create a table which summarises all the published cases in order to draw a conclusion about the epidemiology, as well as the diagnostic and therapeutic approach to PPCs exclusively. We reviewed retrospectively the clinical manifestation, diagnostic and therapeutic approach in 101 cases of PPCs since the 19 th century Results: Our statistical analysis led to the following results: mean age of initial detection: 48.7 ± 17.2 years, female:male ratio: about 3:2, presence of symptomatology: 37/101 cases, most common location: right cardiophrenic angle (RCPA), most common method of initial detection: CXR in 49/101 cases, mean maximal diameter: 8,3 ± 3 cm.
Conclusion:The management of a pleuropericardial cyst should be based on an algorithm in which the cyst's size, shape and compressibility along with clinical presentation and patient's fitness and preferences are be taken into consideration. When interventional is required, surgical resection by means of traditional open surgery or minimally invasive methods are considered to be the gold standard and along with percutaneous aspiration are the methods that have mostly been used.
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