Paracardial Cyst in an Infant with Pleural Effusion: A Case Report

Introduction. Paracardial cysts are rare lesions adjacent to the heart, mostly congenital in origin. They include pericardial and neural cysts, bronchogenic cysts, esophageal duplication cysts, neurenteric cysts, and cysts of other origin. Case report. A four-month-old female was admitted to our department for diagnostic evaluation of a left pleural effusion. The child did not have any difficulties. Computed tomography and magnetic resonance imaging confirmed a giant dumbbell-shaped extrapulmonary multiloculated cyst with fluid-filled cavities, detached from the pericardium, bronchial tree and pleura. Left-sided thoracoscopy confirmed a cystic formation attached to the lung parenchyma, esophagus, pericardium and diaphragm. Its outer surface was glistening and filled with clear fluid. During cyst wall preparation, an opening of the esophageal wall was noticed, and a conversion to the left posterolateral thoracotomy was made. The cyst was removed completely, and the defect of anterior wall of the esophagus was sutured, via the nasogastric tube. Histopathological examination confirmed the diagnosis of a pericardial cyst. Conclusion. Pericardial cysts are rare and often clinically silent. If the existence of these cysts is suspected, a thorough work-up is required in order to make an accurate diagnosis.