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.
Highlights
Pericardial cysts are known as mesothelial, pleuropericardial or pericardial celomic cysts and result CASE REPORTA male 49-year-old patient was admitted to the emergency department with pain on the rightPleuropericardial cyst torsion: case report 229 hemothorax for two days, after physical exertion, which worsened with movement and during inhalation; he presented no dyspnea or fever
Chest radiographs with posteroanterior and lateral views showed a well-defined oval-shaped homogeneous mass, adjacent to the heart, in the right cardiophrenic angle, with a visible rightside heart margin and laminar atelectasis adjacent to it (Figure 1). He was submitted to a computed tomography (CT) scan under a study protocol for pulmonary thromboembolism, based on the patient’s clinical history, which demonstrated the pleuropericardial cyst on the right hemithorax base (Figure 2), with its anterior portion in contact with the pericardial fat and posterior portion in contact with the pleural surface, measuring 17 x 12.5 cm in its longest axis
The spiral shape seen on multidetector CT scan indicated torsion of the mediastinal cyst pedicle
Summary
Study carried out at Hospital Israelita Albert Einstein – HIAE, São Paulo (SP), Brazil. MD; Thoracic Surgeon of Hospital Israelita Albert Einstein – HIAE, São Paulo (SP), Brazil. MD; Post-graduate degree in Computed Tomography and Magnetic Resonance Imaging at Hospital Israelita Albert Einstein – HIAE, São Paulo (SP), Brazil.
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