1
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Koçak S, Hollering P, Vercauteren S. A case series: uniportal VATS excision of pericardial cysts in symptomatic patients. Acta Chir Belg 2024:1-6. [PMID: 38954403 DOI: 10.1080/00015458.2024.2375092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 06/27/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Pericardial cysts are infrequent lesions. Most of these are asymptomatic and incidental findings during investigations for unrelated conditions. When they are symptomatic, they demonstrate most of the time a benign clinical course. Yet, treatment is sometimes necessary. Besides a (temporary) treatment as percutaneous aspiration, there is surgery as a definite treatment. The aim of the paper is to motivate the safety and efficacy of uniportal video assisted thoracoscopy (UVATS) for the excision of (giant) pericardial cysts and describe their (peri-)operative technique. METHODS In this retrospective, single center-based case series, we report all cases with a pericardial cyst who underwent a surgical excision by uniportal VATS (UVATS) between March 2022 and April 2023. Detailed patient characteristics, operation details, hospital length of stay and follow-up data were collected. RESULTS A total of 4 patients underwent excision of a pericardial cyst by UVATS. The follow-up ranged from 10 to 20 months. The mean diameter of the pericardial cyst was 124 mm. Median procedure time was 94 min. No per- and postoperative complications occurred. The median length of postoperative hospital stay was 2 days. All patients showed a clinically relevant improvement of the pre-operative symptoms. CONCLUSIONS Uniportal VATS excision for pericardial cysts is a safe and effective surgical procedure with good outcomes on symptom relief. Though, future comparative studies are urged to elucidate its value among other treatment options.
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Affiliation(s)
- Seher Koçak
- Department of Vascular and Thoracic Surgery, ZNA (Ziekenhuis Netwerk Antwerpen), Antwerp, Belgium
| | - Paul Hollering
- Department of Vascular and Thoracic Surgery, ZNA (Ziekenhuis Netwerk Antwerpen), Antwerp, Belgium
| | - Sven Vercauteren
- Department of Vascular and Thoracic Surgery, ZNA (Ziekenhuis Netwerk Antwerpen), Antwerp, Belgium
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2
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Chalhoub G, Kamel A, Levsky J, Schenone A, Garcia MJ. A Large Cyst in an Unlikely Location: The Interventricular Septum. CASE (PHILADELPHIA, PA.) 2023; 7:401-404. [PMID: 37970483 PMCID: PMC10635888 DOI: 10.1016/j.case.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
•A large cardiac cyst was discovered in an extremely rare location: the IVS. •Pre- and postcontrast imaging is essential in the evaluation of a cystic mass. •When identifying a cardiac cyst, malignancy and infection must be considered. •The benefit of excising a cardiac cyst is unclear in an asymptomatic older patient.
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Affiliation(s)
- George Chalhoub
- Department of Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Andrew Kamel
- Department of Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Jeffrey Levsky
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Aldo Schenone
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Mario J. Garcia
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
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3
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Maidman SD, Bamira D, Vainrib AF, Ro R, Saric M. Cysts Around the Heart: Differential Diagnosis and Multimodality Imaging Strategies for Paracardiac Cysts. CASE (PHILADELPHIA, PA.) 2023; 7:365-376. [PMID: 37791128 PMCID: PMC10543172 DOI: 10.1016/j.case.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
•Paracardiac cysts (located adjacent to or inside the heart) are rarely detected. •There is a broad differential diagnosis for cysts encountered with echocardiography. •Multimodality imaging is crucial for comprehensively evaluating paracardiac cysts.
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Affiliation(s)
- Samuel D. Maidman
- Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Daniel Bamira
- Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Alan F. Vainrib
- Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Richard Ro
- Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Muhamed Saric
- Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
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4
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Morin CE, Griffin LM, Beroukhim RS, Caro-Domínguez P, Chan S, Johnson JN, Infante JC, Lam CZ, Malone LJ, Tang ER, Taylor MD, Wilkinson JC, Masand PM. Imaging of pediatric cardiac tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper. Pediatr Blood Cancer 2023; 70 Suppl 4:e29955. [PMID: 36083866 PMCID: PMC10641876 DOI: 10.1002/pbc.29955] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 11/11/2022]
Abstract
Cardiac tumors in children are rare and the majority are benign. The most common cardiac tumor in children is rhabdomyoma, usually associated with tuberous sclerosis complex. Other benign cardiac masses include fibromas, myxomas, hemangiomas, and teratomas. Primary malignant cardiac tumors are exceedingly rare, with the most common pathology being soft tissue sarcomas. This paper provides consensus-based imaging recommendations for the evaluation of patients with cardiac tumors at diagnosis and follow-up, including during and after therapy.
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Affiliation(s)
- Cara E. Morin
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | | | | | - Pablo Caro-Domínguez
- Pediatric Radiology Unit, Department of Radiology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Sherwin Chan
- Department of Radiology, Children’s Mercy Kansas City, Kansas City, MO; Department of Radiology, University of Missouri at Kansas City School of Medicine, Kansas City, MO
| | - Jason N. Johnson
- Department of Pediatrics and Radiology, The University of Tennessee Health Science Center, Le Bonheur Children’s Hospital, Memphis, TN
| | - Juan C. Infante
- Department of Radiology, Nemours Children’s Hospital, Orlando, FL
| | - Christopher Z. Lam
- Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - LaDonna J. Malone
- Department of Radiology, University of Colorado, Children’s Hospital of Colorado, Aurora, CO
| | - Elizabeth R. Tang
- Radiology Department, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, WA
| | - Michael D. Taylor
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - James C. Wilkinson
- Department of Pediatrics, Division of Pediatric Cardiology, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX
| | - Prakash M. Masand
- Edward B. Singleton Department of Radiology, Texas Children’s Hospital
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5
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Noori MAM, Mohammadian M, Saeed H, Abboud R, Polyak A, Jawed Q, Shah D, Singh P, Ibrahim M, Joshi M. Pericardial Cyst, A Rare Incidental Finding in an Uncommon Location: A Case Report. Cureus 2022; 14:e26037. [PMID: 35859963 PMCID: PMC9288816 DOI: 10.7759/cureus.26037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 12/02/2022] Open
Abstract
A pericardial cyst is one of the rare causes of mediastinal masses. Most of the cases are secondary to congenital incomplete fusion of the pericardial sac. More than two-thirds of the cases are present in the right cardiophrenic angle, and the left cardiophrenic angle is the second most common location. In our study, we illustrated an incidental finding of the pericardial cyst in a patient who presented with nonspecific symptoms and was found to have a left-sided cardiophrenic pericardial cyst, which is only found in about 20% of the cases. A CT scan and echocardiogram confirmed the diagnosis of a 4.39-centimeter cyst with no signs of complications like tamponade or pericarditis. As the patient's symptoms resolved, outpatient follow-up with serial echocardiogram was advised. Through this report, we aim to raise awareness of the importance of further investigation for nonspecific symptoms like atypical chest tightness and differentiating simple pericardial cysts from other pericardial lesions. Based on the symptoms, size, and compression effect of the cyst, management may vary from serial echocardiogram to aspiration or surgical resection.
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6
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Amaqdouf S, Toutai C, Ouafi NE, Bazid Z. Myocardial infarction revealing a pleuropericardial cyst: a case report. Pan Afr Med J 2021; 39:246. [PMID: 34659619 PMCID: PMC8498672 DOI: 10.11604/pamj.2021.39.246.29049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/31/2021] [Indexed: 11/25/2022] Open
Abstract
Pericardial cysts are a rare entity, accounting for 6-7 percent of all mediastinal masses. They are frequently congenital relating to a failure of fusion of mesenchymal layers forming the pericardial space. Pericardial cysts are considered rare incidental findings, they are mostly asymptomatic and benign, however life-threatening complications may occur. Here we present a case of a silent pericardial cyst that was discovered by chance while performing transthoracic echocardiography (TTE) for a man who was admitted for myocardial infarction.
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Affiliation(s)
- Saîda Amaqdouf
- Department of Cardiology, Mohammed VI University Hospital of Oujda, Mohammed First University of Oujda, Oujda, Morocco
| | - Chaimae Toutai
- Department of Cardiology, Mohammed VI University Hospital of Oujda, Mohammed First University of Oujda, Oujda, Morocco
| | - Noha El Ouafi
- Department of Cardiology, Mohammed VI University Hospital of Oujda, Mohammed First University of Oujda, Oujda, Morocco.,Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy, Mohammed the First University of Oujda, Oujda, Morocco
| | - Zakaria Bazid
- Department of Cardiology, Mohammed VI University Hospital of Oujda, Mohammed First University of Oujda, Oujda, Morocco.,Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy, Mohammed the First University of Oujda, Oujda, Morocco
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7
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Terry NLJ, Manapragada PP, Aziz MU, Singh SP. Review of pericardial disease on computed tomography. J Med Imaging Radiat Sci 2021; 52:S65-S77. [PMID: 34588141 DOI: 10.1016/j.jmir.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/23/2021] [Accepted: 09/10/2021] [Indexed: 10/20/2022]
Abstract
Echocardiography has long been the mainstay in the evaluation of cardiac and pericardial disease. As computed tomography (CT) has advanced, it has become a valuable partner in the imaging of the pericardium. The advantages of CT include a larger field of view, multiplanar reconstruction and increased discrimination between various soft tissues and fluids. CT is less operator dependent and can more easily, and reproducibly, image areas of the pericardium for which echocardiography has poor windows such as the right pericardium. The introduction of EKG gating has decreased cardiac motion artifact and can allow functional evaluation although echocardiography remains the primary source of real-time imaging of cardiac and valve motion. It is essential for the skilled cardiac imager to understand the strengths and weaknesses of CT and its role in the definition and assessment of pericardial disease.
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Affiliation(s)
- Nina L J Terry
- University of Alabama at Birmingham, Department of Radiology, Birmingham, AL, USA.
| | - Padma P Manapragada
- University of Alabama at Birmingham, Department of Radiology, Birmingham, AL, USA
| | - Muhammad Usman Aziz
- University of Alabama at Birmingham, Department of Radiology, Birmingham, AL, USA
| | - Satinder P Singh
- University of Alabama at Birmingham, Department of Radiology, Birmingham, AL, USA
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8
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Alwis S, Salmasi MY, Raja SG. A rare case of an intramyocardial mesothelial inclusion cyst. Clin Case Rep 2021; 9:e05024. [PMID: 34721871 PMCID: PMC8543118 DOI: 10.1002/ccr3.5024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/28/2021] [Accepted: 10/08/2021] [Indexed: 11/06/2022] Open
Abstract
A symptomatic intramyocardial cyst, whilst a rare occurrence, is most effectively investigated using Magnetic Resonance Imaging. Furthermore, following diagnosis it can be effectively treated using a surgical approach.
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Affiliation(s)
- Shehani Alwis
- Department of Cardiac SurgeryHarefield HospitalLondonUK
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9
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Alex A, Ayyappan A, Valakkada J, Pillai VV, Sreekantan R, Poyuran R. Pericardial pseudocyst along atrioventricular groove. BJR Case Rep 2020; 7:20200122. [PMID: 33841901 PMCID: PMC8008468 DOI: 10.1259/bjrcr.20200122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 11/22/2022] Open
Abstract
Cystic lesions in relation to the pericardium are a rare congenital lesion with an estimated incidence of 1 per 100,,000. Pericardial cysts may be classified as congenital or acquired. Here, we present a case of a pericardial pseudocyst having a horseshoe configuration along the atrioventricular groove in a middle-aged subject with no previous relevant medical history. The patient underwent open surgery for the same with histopathological diagnosis being established. This paper highlights the differentials for a cystic pericardial lesion in imaging in addition to the histopathological entity of a pericardial pseudocyst.
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Affiliation(s)
- Ajay Alex
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Anoop Ayyappan
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Jineesh Valakkada
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Vivek V Pillai
- Department of Cardiovascular & Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Renjith Sreekantan
- Department of Cardiovascular & Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Rajalakshmi Poyuran
- Department of Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
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10
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Gharedaghi MH, Ahmadi S, Khorasani A, Ebrahimi F. Anesthetic Management of a Patient with a Giant Pericardial Cyst Compressing the Right Atrium. Case Rep Anesthesiol 2019; 2019:2320879. [PMID: 31263601 PMCID: PMC6556248 DOI: 10.1155/2019/2320879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 05/13/2019] [Indexed: 11/20/2022] Open
Abstract
Pericardial cysts are rare mediastinal cysts composed of a single fluid-filled mesothelial layer and can be congenital in origin or develop secondary to pericarditis, trauma, or infection. Although most pericardial cysts are asymptomatic, life-threatening complications can occasionally occur. We report on a 57-year-old man with an asymptomatic 9 cm pericardial cyst that was incidentally found as an abnormal cardiac silhouette on routine chest radiography. Further imaging confirmed the presence of a pericardial cyst that was compressing the right atrium. The patient underwent successful video-assisted thoracoscopic removal of the pericardial cyst under general anesthesia. The patient's postoperative course was uneventful and he was discharged on postoperative day 1 in a stable condition. To our knowledge, this is the first report regarding the anesthetic management of a patient with a giant pericardial cyst undergoing thoracic surgery. Knowledge regarding the perioperative challenges associated with the removal of pericardial cysts can prevent complications and improve patient outcomes.
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Affiliation(s)
- Mohammad Hadi Gharedaghi
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, 836 W Wellington Ave, Suite 4815, Chicago, IL 60657, USA
| | - Saman Ahmadi
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, 836 W Wellington Ave, Suite 4815, Chicago, IL 60657, USA
| | - Arjang Khorasani
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, 836 W Wellington Ave, Suite 4815, Chicago, IL 60657, USA
- Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, USA
| | - Farzad Ebrahimi
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, 836 W Wellington Ave, Suite 4815, Chicago, IL 60657, USA
- Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, USA
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11
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Ünal E, Karcaaltincaba M, Akpinar E, Ariyurek OM. The imaging appearances of various pericardial disorders. Insights Imaging 2019; 10:42. [PMID: 30927107 PMCID: PMC6441059 DOI: 10.1186/s13244-019-0728-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 03/07/2019] [Indexed: 12/15/2022] Open
Abstract
The pericardium could be involved in a variety of clinical disorders. The imaging findings are not specific for an individual pathology in most of the cases; however, patient’s clinical history may guide radiologist to a definitive diagnosis. Congenital absence of the pericardium could be recognized with the imaging appearance of interposed lung tissue between the main pulmonary artery and aorta. Pericardial effusion is a non-specific condition that may occur due to inflammatory, infectious, and neoplastic disorders. Cardiac tamponade may occur in case of massive or rapid accumulation of fluid in the pericardial sac. Pericardial calcification is a common and easily identified entity on a computed tomography (CT) scan. Presence of calcification and/or fibrosis may result in pericardial constriction. Nevertheless, the pulsation of an adjacent coronary artery may prevent calcification formation in a focal area and consequently may result in pericardial diverticulum containing epicardial fat and coronary artery. The imaging findings encountered in patients with pericardial hydatid disease and Erdheim-Chester disease may mimic those of pericardial neoplasia. Pericardial adhesions and pedicled fat flaps may cause confusion on a CT scan in the post-surgical period following cardiac surgery. Pericardial fat necrosis can be diagnosed by CT in patients with chest pain. The radiologists should be familiar with the medical devices placed in pericardial space for certain individual indications. A pericardial patch and temporary epicardial pacemaker wires could be identified on a CT scan.
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Affiliation(s)
- Emre Ünal
- Department of Radiology, School of Medicine, Hacettepe University, 06100, Ankara, Turkey
| | | | - Erhan Akpinar
- Department of Radiology, School of Medicine, Hacettepe University, 06100, Ankara, Turkey
| | - Orhan Macit Ariyurek
- Department of Radiology, School of Medicine, Hacettepe University, 06100, Ankara, Turkey.
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12
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Kar SK, Ganguly T. Current concepts of diagnosis and management of pericardial cysts. Indian Heart J 2017; 69:364-370. [PMID: 28648435 PMCID: PMC5485391 DOI: 10.1016/j.ihj.2017.02.021] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 02/28/2017] [Indexed: 10/29/2022] Open
Abstract
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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Affiliation(s)
- Sandeep Kumar Kar
- Department of Cardiac Anesthesiology, Institute of Post Graduate Medical Education and Research, Kolkata, India.
| | - Tanmoy Ganguly
- Department of Cardiac Anesthesiology, Institute of Post Graduate Medical Education and Research, Kolkata, India
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13
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Ranchordás S, Gomes C, Abecasis M, Gouveia R, Abecasis J, Lopes LR, Fazendas P. Simple mesothelial pericardial cyst in a rare location. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.repce.2015.11.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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14
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Ranchordás S, Gomes C, Abecasis M, Gouveia R, Abecasis J, Lopes LR, Fazendas P. Simple mesothelial pericardial cyst in a rare location. Rev Port Cardiol 2016; 35:497.e1-4. [PMID: 27499504 DOI: 10.1016/j.repc.2015.11.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 11/23/2015] [Indexed: 10/21/2022] Open
Abstract
Pericardial cysts are rare and generally benign intrathoracic lesions, most frequently located in the cardiophrenic angles, but other locations have been described. We present a case of a pericardial cyst in a previously undescribed site. Our patient presented with a cyst in the interventricular septum which was discovered as an incidental finding. After surgical excision of the cyst, it was described pathologically as a simple mesothelial pericardial cyst. The explanation of this rare condition is uncertain, but some hypotheses can be outlined.
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Affiliation(s)
- Sara Ranchordás
- Cardiac Surgery Department, Santa Cruz Hospital, Carnaxide, Portugal.
| | - Catarina Gomes
- Cardiology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Miguel Abecasis
- Cardiac Surgery Department, Santa Cruz Hospital, Carnaxide, Portugal
| | - Rosa Gouveia
- Pathology Department, Santa Cruz Hospital, Carnaxide, Portugal
| | - João Abecasis
- Cardiology Department, Santa Cruz Hospital, Carnaxide, Portugal
| | - Luís R Lopes
- Cardiology Department, Hospital Garcia de Orta, Almada, Portugal; CCUL, University of Lisbon, Lisbon, Portugal
| | - Paula Fazendas
- Cardiology Department, Hospital Garcia de Orta, Almada, Portugal
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16
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Abstract
OBJECTIVE The purpose of this article is to describe the characteristic cardiac MRI features of primary and secondary cardiac tumors, including differentiation from masslike lesions, such as thrombus or focal myocardial hypertrophy. CONCLUSION The frequency and type of cardiac tumors in children differ from those in adults. Although transthoracic echocardiography is the initial imaging technique of choice for evaluation of cardiac tumors, cardiac MRI is an important complementary modality for characterization of the mass and effect on cardiac function.
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17
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Restrepo CS, Vargas D, Ocazionez D, Martínez-Jiménez S, Betancourt Cuellar SL, Gutierrez FR. Primary pericardial tumors. Radiographics 2014; 33:1613-30. [PMID: 24108554 DOI: 10.1148/rg.336135512] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Primary pericardial tumors are rare and may be classified as benign or malignant. The most common benign lesions are pericardial cysts and lipomas. Mesothelioma is the most common primary malignant pericardial neoplasm. Other malignant tumors include a wide variety of sarcomas, lymphoma, and primitive neuroectodermal tumor. When present, signs and symptoms are generally nonspecific. Patients often present with dyspnea, chest pain, palpitations, fever, or weight loss. Although the imaging approach usually begins with plain radiography of the chest or transthoracic echocardiography, the value of these imaging modalities is limited. Cross-sectional imaging, on the other hand, plays a key role in the evaluation of these lesions. Computed tomography and magnetic resonance imaging allow further characterization and may, in some cases, provide diagnostic findings. Furthermore, the importance of cross-sectional imaging lies in assessing the exact location of the tumor in relation to neighboring structures. Both benign and malignant tumors may result in compression of vital mediastinal structures. Malignant lesions may also directly invade structures, such as the myocardium and great vessels, and result in metastatic disease. Imaging plays an important role in the detection, characterization, and staging of pericardial tumors; in their treatment planning; and in the posttreatment follow-up of affected patients. The prognosis of patients with benign tumors is good, even in the few cases in which surgical intervention is required. On the other hand, the length of survival for patients with malignant pericardial tumors is, in the majority of cases, dismal.
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Affiliation(s)
- Carlos S Restrepo
- Department of Radiology, University of Texas Health Science Center, San Antonio, Tex
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