Rare.uncommon benign Intrathoracic congenital anomaly.
Caused by an incomplete coalescence of fetal lacunae forming the pericardium.
Congenital in origin and thought to form from when there is in complete fusion of somatic cavities.
These are benign lesions that are usually asymptomatic and found incidentally on chest x-ray or CT scan.
Pericardial cysts account for 7% of mediastinal masses and 33% of cystic mediastinal masses.
While they are most commonly found in the right cardiophrenic but can occur anywhere in the mediastinum.
Incidence estimated at 1 to 100,000.
More than 60% of discovered between the ages of 30 and 50 years.
70% of cysts localized to the right cardio phrenic angle.
Can develop along the upper mediastinum, hilus, or cardiac border.
The lesions are typically unilocular.
Typically lined by endothelium or mesothelium and contain serous fluid.
Does not communicate with the pericardial space.
Usually asymptomatic and found incidentally.
Maybe associated with chest pain, tachyarrhythmias, cough, and lower respiratory tract infections.
When asymptomatic may require no therapy.
Typically filled with serous fluid but can have proteinaceous material, making them higher density on CT and sometimes indeterminate.
MRI can be useful in confirming the diagnosis.
Cysts have no contrast enhancement on MRI or CT.
Lesions have been reported to spontaneously resolve.
In the presence of rapid enlargement or significant symptomatology, surgical resection or drainage may be feasible.