Massive benign pericardial cyst presenting with simultaneous superior vena cava and middle lobe syndromes

Pankaj Kaul , Kalyana Javangula and Shahme A Farook

Yorkshire Heart Centre, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK

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Journal of Cardiothoracic Surgery 2008, 3:32doi:10.1186/1749-8090-3-32


Published:	21 May 2008

Abstract

A 66 year old woman presented in extremis with symptoms and clinical and radiological signs of simultaneous obstruction of superior vena cava and middle lobe of right lung secondary to compression by a massive benign anterior mediastinal cyst. Excision of the cyst at median sternotomy resulted in complete resolution of all symptoms. This report is unusual on account of a) the concomitant presence of superior vena cava and middle lobe syndromes caused by a benign cyst because of its sheer size producing obstruction of these structures and b) the complete resolution of all symptoms and signs after removal of the cyst. Benign anterior mediastinal cysts are unknown to cause either of the two syndromes. To our knowledge, it is the first report of a benign anterior mediastinal cyst causing either superior vena cava syndrome or middle lobe syndrome or both simultaneously. Etiologies of both superior vena cava and middle lobe syndromes are discussed in detail.