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Pericardial cyst with right aortic arch

Case contributed by George Harisis
Diagnosis almost certain

Presentation

Asymptomatic. Screening chest x-ray prior to abdominal surgery.

Patient Data

Age: 60 years
Gender: Male

Chest X-ray

x-ray

In the right cardiophrenic region is a soft tissue density, smoothly marginated mass obscuring the right heart border. Pulmonary vessels can be seen through the lesion. The left heart border is unremarkable. The lungs and pleural spaces are clear. An incidental right sided aortic arch is noted. 

Case Discussion

Differentials for the right mediastinal mass include teratoma, pericardial cyst and a Morgagni-type hernia. In this case,  external imaging had confirmed a pericardial cyst along with incidental right sided aortic arch. Both entities are relatively uncommon in the general population.  

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