Epicardial mesothelial cyst located over the left anterior descending coronary artery

Area of Science:

• Cardiology
• Surgical Pathology
• Cardiac Surgery

Background:

• Pericardial cysts are rare congenital anomalies, typically found in the anterior mediastinum.
• Epicardial origin is an exceptionally uncommon presentation for these cysts.
• This case highlights a rare instance of a pericardial cyst arising directly from the epicardium.

Observation:

• A 30-year-old female patient with a history of rheumatic fever presented for open-heart surgery.
• Severe aortic and mitral insufficiency necessitated surgical intervention.
• A cyst was incidentally discovered overlying the left anterior descending coronary artery during the procedure.

Findings:

• The cyst was surgically excised using cardiopulmonary bypass to ensure the safety of the coronary artery.
• Histopathological examination confirmed the cyst was lined by a single layer of benign mesothelial cells.
• The findings were consistent with a diagnosis of an epicardial mesothelial cyst.

Implications:

• This case contributes to the limited literature on epicardial mesothelial cysts.
• Understanding the origin and characteristics of such rare cysts is crucial for surgical planning and patient management.
• Further research may elucidate the embryological basis and clinical significance of epicardial mesothelial cysts.