[A case of an intra-pericardial bronchogenic cyst requiring an emergency operation]

The patient was a 36-year-old male, who complained of anterior chest pain and dyspnea. A chest X-ray showed a cardiac enlargement and widened tracheal carina. A cardiac echography showed an intra-pericardial simple cyst which was fixed and did not move with cardiac motion. CT showed a cyst, measuring to 10 cm between the left atrium and vertebra. An angiography revealed that the left atrium and right main pulmonary artery were compressed in the anterior direction. Because his symptoms deteriorated suddenly, an emergency operation was performed. The intrapericardium was explored through the right postero-lateral thoracotomy, and the cyst was resected. A microscopic examination revealed that the cystic wall was lined with ciliated columnar epithelium and contained cartilage and bronchial gland. Review of the literatures indicated that the most of the intra-pericardial bronchogenic cysts were revealed as cardiac enlargement by chest X-ray film, and that the cyst compressing the atrium or main pulmonary artery should be resected without delay, because of a risk of sudden death or cardiac failure.