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Giant pericardial cyst in a 5-year-old child: A rare anomaly.

Kumar S, Jain P, Sen R, Rattan K, Agarwal R, Garg S - Ann Pediatr Cardiol (2011)

Bottom Line: The child presented with chest pain, cough and fever.It was confirmed on histopathology after successful surgical excision.The rarity of this benign mediastinal lesion in children prompted us to report this case.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Post Graduate Institute of Medical Sciences, Rohtak - 124 001, Haryana, India.

ABSTRACT
Pericardial cysts are uncommon congenital abnormalities that occur in the middle mediastinum. Most of these are found incidentally on chest x-rays. The occurrence of pericardial cyst in children is quite rare. It needs to be differentiated from other cystic mediastinal masses. A rare case of pericardial cyst in a 5 year old male child is reported. The child presented with chest pain, cough and fever. The preoperative diagnosis of pericardial cyst was suggestive on echocardiography and CT scan. It was confirmed on histopathology after successful surgical excision. The rarity of this benign mediastinal lesion in children prompted us to report this case.

No MeSH data available.


Related in: MedlinePlus

CT scan showing a huge pericardial cyst in the anterior mediastinum displacing the heart
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Figure 1: CT scan showing a huge pericardial cyst in the anterior mediastinum displacing the heart

Mentions: A 5-year-old male child presented with history of dull aching chest pain for the last 3 months. It was associated with low-grade intermittent fever and nonproductive cough for the last 20 days. The child's birth history was uneventful, with a birth weight of 2.8 kg, and he was fully immunized as per the schedule. On examination, the patient was sick and pale, with a pulse rate of 136/min. The respiratory system examination revealed bilaterally clear chest. On precordial examination, the heart sounds were soft and feeble. An abdominal examination revealed palpable liver, which was 5 cm below the costal margin. On hematological investigation, hemoglobin was 10.5 gm%, with a white blood cell count of 6.0 × 109/l and a platelet count of 350 × 109/l. The chest radiograph revealed widened mediastinum. An echocardiography suggested a large cystic lesion occupying the anterior mediastinum and compressing both the right and left ventricles and the right atrium. On contrast-enhanced computed tomography (CECT), a large cystic mass in the middle mediastinum was identified. It was seen extending from just above the arch of the aorta and up to the diaphragm. The cyst was displacing the great vessels, trachea and heart posteriorly [Figure 1]. Both the lung fields were clear and the heart chambers were normal in size, but were compressed posteriorly. The differential diagnoses of thymic cyst, lymphangioma, hydatid cyst and pericardial cyst were considered. The cyst was excised by median sternotomy. A large pericardial cystic structure measuring approximately 10.0 cm × 9.5 cm × 9.0 cm was seen loosely adherent to the pericardium [Figure 2]. Its outer surface was glistening and was filled with clear fluid. Histopathological examination revealed the structure of a cyst lined with flattened mesothelial cells suggestive of pericardial cyst. The postoperative period was uneventful and the patient is doing well in follow-up.


Giant pericardial cyst in a 5-year-old child: A rare anomaly.

Kumar S, Jain P, Sen R, Rattan K, Agarwal R, Garg S - Ann Pediatr Cardiol (2011)

CT scan showing a huge pericardial cyst in the anterior mediastinum displacing the heart
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3104539&req=5

Figure 1: CT scan showing a huge pericardial cyst in the anterior mediastinum displacing the heart
Mentions: A 5-year-old male child presented with history of dull aching chest pain for the last 3 months. It was associated with low-grade intermittent fever and nonproductive cough for the last 20 days. The child's birth history was uneventful, with a birth weight of 2.8 kg, and he was fully immunized as per the schedule. On examination, the patient was sick and pale, with a pulse rate of 136/min. The respiratory system examination revealed bilaterally clear chest. On precordial examination, the heart sounds were soft and feeble. An abdominal examination revealed palpable liver, which was 5 cm below the costal margin. On hematological investigation, hemoglobin was 10.5 gm%, with a white blood cell count of 6.0 × 109/l and a platelet count of 350 × 109/l. The chest radiograph revealed widened mediastinum. An echocardiography suggested a large cystic lesion occupying the anterior mediastinum and compressing both the right and left ventricles and the right atrium. On contrast-enhanced computed tomography (CECT), a large cystic mass in the middle mediastinum was identified. It was seen extending from just above the arch of the aorta and up to the diaphragm. The cyst was displacing the great vessels, trachea and heart posteriorly [Figure 1]. Both the lung fields were clear and the heart chambers were normal in size, but were compressed posteriorly. The differential diagnoses of thymic cyst, lymphangioma, hydatid cyst and pericardial cyst were considered. The cyst was excised by median sternotomy. A large pericardial cystic structure measuring approximately 10.0 cm × 9.5 cm × 9.0 cm was seen loosely adherent to the pericardium [Figure 2]. Its outer surface was glistening and was filled with clear fluid. Histopathological examination revealed the structure of a cyst lined with flattened mesothelial cells suggestive of pericardial cyst. The postoperative period was uneventful and the patient is doing well in follow-up.

Bottom Line: The child presented with chest pain, cough and fever.It was confirmed on histopathology after successful surgical excision.The rarity of this benign mediastinal lesion in children prompted us to report this case.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Post Graduate Institute of Medical Sciences, Rohtak - 124 001, Haryana, India.

ABSTRACT
Pericardial cysts are uncommon congenital abnormalities that occur in the middle mediastinum. Most of these are found incidentally on chest x-rays. The occurrence of pericardial cyst in children is quite rare. It needs to be differentiated from other cystic mediastinal masses. A rare case of pericardial cyst in a 5 year old male child is reported. The child presented with chest pain, cough and fever. The preoperative diagnosis of pericardial cyst was suggestive on echocardiography and CT scan. It was confirmed on histopathology after successful surgical excision. The rarity of this benign mediastinal lesion in children prompted us to report this case.

No MeSH data available.


Related in: MedlinePlus