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Review
. 2015 May 12:9:110.
doi: 10.1186/s13256-015-0582-z.

Pancreatic mediastinal pseudocyst presenting as a posterior mediastinal mass with recurrent pleural effusions: a case report and review of the literature

Vasilis Karamouzos  1 , Dimitrios Karavias  2 , Dimitrios Siagris  3 , Christina Kalogeropoulou  4 , Fay Kosmopoulou  5 , Charalampos Gogos  6 , Dimitrios Velissaris  7
Affiliations
Review

Pancreatic mediastinal pseudocyst presenting as a posterior mediastinal mass with recurrent pleural effusions: a case report and review of the literature

Vasilis Karamouzos et al. J Med Case Rep. .

Abstract

Introduction: A rare complication of chronic pancreatitis is the formation of single or multiple mediastinal pseudocysts, which are fueled from the pancreas through anatomical openings of the diaphragm. We present a rare case with a difficult diagnosis, treatment and potentially catastrophic complications.

Case presentation: A 53-year-old Caucasian man was referred to our hospital for further investigation and treatment of a large heterogeneous mass situated in the posterior mediastinum, and bilateral pleural effusions which had developed after recent multiple episodes of pancreatitis. He had a history of chronic alcoholism. Laboratory and imaging modalities established the diagnosis of a pancreatic mediastinal pseudocyst.

Conclusions: Despite successful initial conservative treatment, our patient had a relapse and underwent emergency surgical intervention due to internal hemorrhage. We present his diagnostic and imaging workup, along with the multidisciplinary intervention, and a literature review referring to the diagnosis and treatment of mediastinal pancreatic pseudocysts.

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Figures

Figure 1
Figure 1
Axial post-contrast computed tomography scan at the level of the lower mediastinum reveals a mass (arrow) and bilateral pleural effusions (arrow heads).
Figure 2
Figure 2
Nine months earlier, an axial post-contrast computed tomography scan reveals no abnormality in the mediastinum. A small pleural effusion is present at the left hemithorax (arrow).
Figure 3
Figure 3
Post-contrast chest computed tomography scan after successful pleural drainage. Panel A: Fluid collection (*) in front of esophagus (arrow) and a small pleural effusion is present (arrow head). Panel B: Sagittal reconstructed images demonstrate a longitudinal fluid collection (* *) in the mediastinum, along the lower esophagus (arrow), measuring 3×8cm. The lesion was compatible with a mediastinum pseudocyst.
Figure 4
Figure 4
Post-contrast computed tomography scan of the upper abdomen reveals a small pseudocyst of 2cm at the pancreatic tail (arrow).
See this image and copyright information in PMC

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