Calcified pleuropericardic cysts--2 cases report

Pleuropericardic cysts represent 5 to 7 per cent of tumours of the mediastinum. Their origin is a defect in development of pericardic coelomic cavities. They are located in the right and cardio-phrenic corner in 70 per cent of cases. They are generally asymptomatic. They are best treated by a thin needle puncture under scanography. Surgery is needed only when the cyst wall is thick. We have treated surgically 2 cases of large cysts, because of their sizes (10 cm and 13 cm of diametres respectively), and, mostly, because of their calcification. Symptomatology was dominated by respiratory signs, such as dyspnea. In one case, there were manifestations of inferior vena cava compression. Diagnosis was done by roentgenography of the thorax. The surgical procedure, using right thoracotomy, revealed a calcified cyst in both cases, with a tough wall, which was resected. In one case, the removal of adhesion to the inferior vena cava injured this vessel which was sutured after partial clamping. Hemorrhage was severe and 2.51 blood transfusion was necessary. The post operative course was uneventful. Clinical signs of compression disappeared in both cases.