“Spring Water” Cyst of the Mediastinum

Greenfield, Irving; Steinberg, Israel; Touroff, Arthur S. W.

doi:10.1016/s0096-5588(20)31894-8

Cited by 33 publications

(9 citation statements)

References 2 publications

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“…Greenfield et al coined the term ‘springwater cysts’ because of the presence of thin, transparent cyst wall and crystal clear fluid content within the pericardial cyst. 17 Surgical approach to the pericardial cysts and diverticula has undergone several refinements with the present evidence based medical diagnosis and treatment approach. Currently video assisted thoracoscopic surgery is considered as the most promising technique in the diagnosis and in the management of these lesions.…”

Section: Historymentioning

confidence: 99%

“…The interrelationship between pericardial diverticulum and cyst sharing a common embryonic origin was first recognised in this case series. 23 1931 Wallace Yater (Georgetown University) detailed the radiological appearance and the differential diagnosis of pericardial cysts 25 1931 Otto Pickhardt, at Lenox Hill Hospital in New York performed first surgical removal of pericardial cyst 15 1937 First pneumogram of pericardial cyst was performed by E. H. Cushing 26 1940 Adrian Lambert first suggested similar embryological origin of pericardial cyst and diverticula from disconnected mesenchymal lacunae, which later unite to form the pericardial coelom 27 1943 First resection of a pericardial diverticulum by Richard Sweet at Massachusetts General Hospital in Boston 29 1943 Greenfield et al introduced the term ‘Springwater cyst’ 17 1958 Le Roux reported the incidence of three cases of pericardial cysts in 300,000 people in a mass X-ray campaign in Edinburgh 14 …”

Section: Historymentioning

confidence: 99%

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Current concepts of diagnosis and management of pericardial cysts

Kar

Ganguly

2017

Indian Heart Journal

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Pericardial cysts are rare with an incidence of about 1 in every 100,000 persons and one in 10 pericardial cysts may actually be a pericardial diverticulum. Pericardial cysts and diverticula share similar developmental origin and may appear as an incidental finding in chest roentgenogram in an asymptomatic patient. CT scan is considered as best modality for diagnosis and delineation of the surrounding anatomy. Cardiac MRI is recommended in the evaluation of the compressive effects caused by the pericardial cysts. The authors recommend echocardiography for serial follow up and image guided aspiration of the pericardial cyst in presence of compressive effects leading to cardiovascular and airway symptoms. A systematic approach is desirable for management of pericardial cysts depending on size, shape and compression effects, symptoms and easy access to serial Echocardiographic follow up. However, pericardial diverticulum may not be differentiated from cysts by the above testing, and only identified at surgery.

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Section: Historymentioning

confidence: 99%

Section: Historymentioning

confidence: 99%

Current concepts of diagnosis and management of pericardial cysts

Kar

Ganguly

2017

Indian Heart Journal

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“…The appearance of the thin-walled, translucent cysts containing crystal-clear fluid gave rise to the name “spring water cysts.” Greenfield and colleagues introduced the new term into the medical literature when they encountered a cyst filled with “crystal-clear fluid of watery consistency” in 1943 [6] . Thin-walled solitary cysts with a low uniform density can be diagnosed as congenital thymic cysts according to their appearance on CT and MRI [7] .…”

Section: Discussionmentioning

confidence: 99%

Should spring water cysts of the mediastinum require excisional resection? A case report

Kiya¹,

Nakamoto²,

Fujii³

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance Mediastinal cysts account for 20–32% of all mediastinal lesions. Complete surgical excision is the standard therapy for mediastinal cysts. Translucent cysts containing crystal-clear fluid are called “spring water cysts.” We experienced a case of mediastinal spring water cyst fenestrated under video-assisted thoracoscopy with a miniaturized endoscope (mini-VATS) as an alternative to excisional resection. Case presentation A 49-year-old woman presented with back pain. Chest CT revealed a posterior mediastinal mass measuring 4.2 × 1.8 × 3.2 cm closed to the tenth thoracic vertebra. Chest MRI demonstrated hypo-intensity on T1-weighted images and hyper-intensity on T2-weighted images. It was estimated that the posterior mediastinal mass did not contain a tumor component. The tumor was growing and symptomatic; therefore, we performed surgical cyst fenestration without excision of the cyst under mini-VATS. The patient experienced complete relief of symptoms. Fluid accumulation in the cyst was not observed on CT images 12 months postoperatively. Clinical discussion Kozu et al. reported that all 108 primary mediastinal cysts were resected completely and were recurrence-free after a mean follow-up of 41 ± 26 months. In the case of a functional hydrocele such as spring water cyst, we believe that even if fluid is produced, the thoracic pleura is capable of absorbing the fluid, and the cyst wall might not recur even if the wall is left in place. Fluid drainage through fenestration may prevent recurrent fluid collection. Conclusion Fenestration of non-neoplastic mediastinal cysts under mini-VATS might be a less invasive radical procedure compared to complete resection.

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“…The appearance of the thin-walled, translucent cysts containing crystal-clear fluid gave rise to the name "spring water cysts." Greenfield and colleagues introduced the new term into the medical literature when they encountered a cyst filled with "crystal-clear fluid of watery consistency" in 1943 [5]. Thin-walled solitary cysts with a low uniform density can be diagnosed as congenital thymic cysts according to their appearance on CT and MRI [6].…”

Section: Mediastinal Spring Water Cystsmentioning

confidence: 99%

Should Spring Water Cysts of the Mediastinum Require Excisional Resection?

Kiya¹,

Nakamoto²,

Fujii³

et al. 2021

Preprint

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Complete surgical excision is the standard therapy for mediastinal cysts. Translucent cysts containing crystal-clear fluid are called “spring water cysts.” We considered that these cysts can be treated adequately using fenestration with minimal bleeding and damage to existing structures. We experienced a case of mediastinal spring water cyst fenestrated under video-assisted thoracoscopy with a miniaturized endoscope (mini-VATS), instead of excisional resection. Fenestration of the non-neoplastic mediastinal cyst under mini-VATS might be a less invasive radical procedure and an alternative to complete resection. We discuss the indication for surgery and the surgical procedure for non-neoplastic mediastinal cyst with crystal-clear fluid.

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“Spring Water” Cyst of the Mediastinum

Cited by 33 publications

References 2 publications

Current concepts of diagnosis and management of pericardial cysts

Current concepts of diagnosis and management of pericardial cysts

Should spring water cysts of the mediastinum require excisional resection? A case report

Should Spring Water Cysts of the Mediastinum Require Excisional Resection?

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