Key result
Contrast 3D TEE accurately defines the intrapericardial origin and nonvascular nature of a mediastinal cyst.
Why the study?
Pericardial cysts in the central mediastinum are extremely unusual and require precise imaging to clarify their localization and nature.
Case Report (n=1)
Contrast-enhanced 3D TEE can provide incremental diagnostic value in localizing and characterizing unusual mediastinal cysts, potentially avoiding unnecessary surgery.
May aid mediastinal cyst characterization in select cases; hypothesis-generating and should not yet change practice.
We report a case of a 76-year-old man, with the occasional finding of a mediastinal cyst because of subtle chronic dysphagia associated to sore throat, belching, and dysphonia. The paraesophageal cyst in the central mediastinum was studied with computed tomography (CT) scan and transesophageal three-dimensional (3D) echocardiography with contrast echo. In order to clarify doubts about localization (intra- versus extrapericardial) of the mediastinal cystic lesion the 3D transesophageal echocardiography (TEE) confirmed the presence of a large round cystic mass located contiguous to the esophagus, the left atrium and the aortic root/pulmonary trunk (located at the front of the lesion), as well as located intrapericardial. The cystic mass showed no blood flow at color Doppler mode and at ultrasound contrast echo with SonoVue agent. Due to the paucity of symptoms and to the definite imaging information of this intrapericardial cyst of nonvascular nature, due to pericardial cyst in an extremely unusual location, surgery was not performed. At follow-up of 1 month echocardiogram and 3 month CT scan the cyst appeared unchanged in dimensions.
No takes yet. Share an insight, caveat, or question.
Colonna et al. (2013) conducted a case report in Pericardial cyst in the central mediastinum (n=1). Three-dimensional transesophageal echocardiography with contrast echo was evaluated on Localization and characterization of the mediastinal cystic lesion. Three-dimensional transesophageal echocardiography with contrast confirmed the intrapericardial location and nonvascular nature of a large mediastinal cyst in a 76-year-old man.