Mediastinal pancreatic pseudocyst with isolated thoracic symptoms: a case report

Abstract

Introduction: Mediastinal pancreatic pseudocysts represent a rare complication of acute or chronic pancreatitis.

Case presentation: A 55-year-old man with a history of chronic pancreatitis was admitted with intermittent dyspnea, dysphagia and weight loss. Chest X-ray, computed tomography and magnetic resonance imaging revealed a large paracardial pancreatic pseudocyst causing cardiac and esophageal compression.

Conclusion: Mediastinal pancreatic pseudocysts are a rare complication of chronic pancreatitis. These pseudocysts may lead to isolated thoracic symptoms. For accurate diagnostic and therapy planning, a multimodal imaging approach is necessary.

Figure 1

Chest X-ray on admission. Initial examination showed an intrathoracic mass overlying the left margin of the heart (arrowheads). No interstitial pulmonary edema was noted. Small pleural effusions are shown.

Figure 2

Contrast-enhanced computed tomography scan of the chest-abdomen. A large cystic lesion is compressing the heart, predominantly the left ventricle (arrowheads).

Figure 3

T2-weighted coronal magnetic resonance imaging of the upper abdomen and magnetic resonance cholangiopancreatography. There is communication between mediastinal and abdominal pseudocysts through the esophageal hiatus. High-grade ductal stenosis (arrowhead) is shown, but only a slight widening in the pancreatic body and tail.