Surgical resection of a rare giant calcified pericardial cyst with caseous degeneration successfully relieved right ventricular compression and preserved cardiac function.
Highlights the diagnostic and surgical considerations for rare, complex calcified pericardial cysts with atypical caseous contents causing right ventricular compression.
Abstract Calcified pericardial cysts are exceedingly rare, and cysts containing caseous material are scarcely reported. We describe a giant calcified pericardial cyst causing right ventricular compression and heart failure symptoms. Imaging demonstrated a large calcified pericardial mass abutting the right ventricle and atrioventricular groove. Surgical resection via median sternotomy with anterior pericardiectomy was performed. Intraoperatively, thick caseous material was found within a heavily calcified cyst wall. Histopathology revealed a fibrous cyst wall without epithelial lining and no evidence of malignancy or granulomatous inflammation. Post-resection transoesophageal echocardiography confirmed relief of right ventricular compression with preserved function. This case highlights diagnostic challenges and surgical considerations of complex calcified pericardial cysts with atypical intracystic contents.
Kawaguchi et al. (2026) studied this question. Surgical resection of a rare giant calcified pericardial cyst with caseous degeneration successfully relieved right ventricular compression and preserved cardiac function.