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Giant Calcified Pericardial Cyst With Caseous Degeneration Causing Right Ventricular Compression
Yasuhiko Kawaguchi1, Badr Arbaein2, Raffael Pereira Cezar Zamper2
1Division of Cardiac Surgery, London Health Science Centre, Western University, London, Ontario, N5X 5A5, Canada.
Interdisciplinary Cardiovascular and Thoracic Surgery
|April 12, 2026
Summary
Giant calcified pericardial cysts are rare, especially those with caseous material. This case details a large calcified pericardial cyst causing heart failure, successfully treated with surgical resection.
Area of Science:
- Cardiology
- Thoracic Surgery
- Pathology
Background:
- Calcified pericardial cysts are rare, with caseous material being exceptionally uncommon.
- Giant pericardial cysts can lead to significant cardiac compression and heart failure.
Purpose of the Study:
- To describe a rare case of a giant calcified pericardial cyst with atypical caseous contents.
- To highlight the diagnostic and surgical challenges associated with such complex cases.
Main Methods:
- Case report of a patient with a giant calcified pericardial cyst.
- Diagnostic imaging including echocardiography.
- Surgical resection via median sternotomy with anterior pericardiectomy.
- Histopathological examination of the resected cyst.
Main Results:
- A large calcified pericardial cyst causing right ventricular compression and heart failure symptoms was identified.
- Surgical resection revealed a heavily calcified cyst wall containing thick caseous material.
- Histopathology confirmed a fibrous cyst wall without malignancy or granulomatous inflammation.
- Post-operative echocardiography showed relief of right ventricular compression and preserved cardiac function.
Conclusions:
- Giant calcified pericardial cysts with caseous material present unique diagnostic and surgical challenges.
- Surgical resection is an effective treatment for relieving cardiac compression and improving heart failure symptoms.
- Thorough histopathological examination is crucial for accurate diagnosis and to rule out other pathologies.
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