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[Pericardial cysts. Report on 9 treated cases]
P Volpino1, A De Cesare, M Bononi
1I Istituto di Clinica Chirurgica, Università degli Studi La Sapienza, Roma.
Insights
This study reviewed nine pericardial cyst cases, finding surgical thoracotomy effective for most. Percutaneous drainage offered a successful alternative for one patient, with no complications observed.
Area of Science:
- Cardiology
- Thoracic Surgery
- Diagnostic Imaging
Background:
- Pericardial cysts are rare congenital anomalies, often asymptomatic and incidentally discovered.
- Their location and clinical presentation can vary, impacting diagnostic approaches.
- Management strategies range from observation to surgical intervention.
Purpose of the Study:
- To review the clinical presentation, diagnostic methods, and treatment outcomes of pericardial cysts.
- To evaluate the efficacy and safety of different management modalities.
- To identify factors influencing diagnostic accuracy and treatment success.
Main Methods:
- Retrospective analysis of nine patients treated for pericardial cysts between 1976 and 1993.
- Review of diagnostic imaging (e.g., CT scans) and surgical records.
- Surgical interventions included posterolateral/axillary thoracotomy and CT-guided percutaneous drainage.
Main Results:
- Six cysts were located in the right cardiophrenic angle, with preoperative diagnosis being most accurate for these typical locations.
- Four patients were asymptomatic; eight underwent surgical treatment with no operative morbidity or mortality.
- One patient with a large cyst successfully managed with CT-guided percutaneous drainage.
Conclusions:
- Pericardial cysts can be effectively managed with surgical resection or percutaneous drainage.
- Accurate preoperative diagnosis is often dependent on cyst location.
- Both surgical and minimally invasive approaches offer favorable outcomes with low complication rates.
Abstract:
From 1976 to 1993, nine patients (5 men, 4 women) with pericardial cysts were treated in Authors' Department. Of the nine cysts, six were located in the right cardiophrenic angle, one in the subcarinal site, one in the right tracheobronchial angle, and one in the para-auricular site just above the diaphragm. Four patients were asymptomatic. A correct diagnosis was possible preoperatively only in patients with cysts typically located in the cardiophrenic angle. Eight patients were surgically treated by a standard posterolateral or axillary thoracotomy. One patient with a large pericardial cyst underwent needle percutaneous aspiration and CT-guided drainage of the cyst with a positive outcome. There was no operative morbidity or mortality.