Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2025 Jul 2:13:1613764.
doi: 10.3389/fped.2025.1613764. eCollection 2025.

An anterior mediastinal cystic lesion pathologically confirmed as a mediastinal pancreatic pseudocyst after thoracoscopic resection: a rare case report and literature review

Kui Zhai #  1 , Xingpeng Miao #  1 , Guiling Xue  1 , Zhanyu Yuan  2 , Mao Jia  2 , Mingyan Chen  3 , Renzhong Zha  1
Affiliations
Case Reports

An anterior mediastinal cystic lesion pathologically confirmed as a mediastinal pancreatic pseudocyst after thoracoscopic resection: a rare case report and literature review

Kui Zhai et al. Front Pediatr. .

Abstract

Background: Mediastinal lesions have diverse etiologies, with thymoma, cystic teratoma, and lymphoma being relatively prevalent. In contrast, a pancreatic pseudocyst within the mediastinum is exceedingly rare and can often be mistaken for a thymic cyst or teratoma.

Case presentation: A 17-year-old female presented with a cough and sputum production. Chest CT revealed an anterior mediastinal mass, initially raising the suspicion of a thymic cyst. Thoracoscopic exploration and resection revealed a cystic lesion with a thick wall and brownish fluid. Both frozen section and final histopathological analysis confirmed a mediastinal cyst. Immunohistochemical markers (SYN positive, CK7 positive) led to a diagnosis of mediastinal pancreatic pseudocyst. The patient experienced significant recovery post-surgery, with a marked improvement in symptoms.

Conclusion: This case highlights the importance of including mediastinal pancreatic pseudocyst in the differential diagnosis of anterior mediastinal cystic lesions. A thorough clinical and radiological assessment, along with surgical pathology and immunohistochemical profiling, is essential for accurate diagnosis and appropriate management.

Keywords: CT; anterior mediastinal cystic mass; mediastinal pancreatic lesion; pancreatic pseudocyst; x-ray.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Preoperative imaging studies. (A) Preoperative chest x-ray; (B) sagittal view of contrast-enhanced chest CT; (C) coronal view of contrast-enhanced chest CT; (D) lung window of plain chest CT; (E) mediastinal window of plain chest CT; (F) axial view of contrast-enhanced chest CT. The arrows indicate the location of the lesion.
Figure 2
Figure 2
Intraoperative photographs. (A) Location of the lesion; (B) brown fluid aspirated from the cystic cavity; (C) complete resection of the lesion; (D) resected specimen, showing a cystic structure.
Figure 3
Figure 3
Immunohistochemical findings of the resected lesion. (A)SYN (Synaptophysin) positive; (B) CK7 (Cytokeratin 7) positive; (C) CK20 (Cytokeratin 20) negative; (D) MUC-5ac (Mucin 5AC) negative.
Figure 4
Figure 4
Postoperative follow-up chest x-ray, indicating complete removal of the lesion.
See this image and copyright information in PMC

References

    1. Koo JG, Liau MYQ, Kryvoruchko IA, Habeeb TA, Chia C, Shelat VG. Pancreatic pseudocyst: the past, the present, and the future. World J Gastrointest Surg. (2024) 16:1986–2002. 10.4240/wjgs.v16.i7.1986 - DOI - PMC - PubMed
    1. Karamouzos V, Karavias D, Siagris D, Kalogeropoulou C, Kosmopoulou F, Gogos C, et al. Pancreatic mediastinal pseudocyst presenting as a posterior mediastinal mass with recurrent pleural effusions: a case report and review of the literature. J Med Case Rep. (2015) 9:110. 10.1186/s13256-015-0582-z - DOI - PMC - PubMed
    1. Ajmera AV, Judge TA. Mediastinal extension of pancreatic pseudocyst–a case with review of topic and management guidelines. Am J Ther. (2012) 19:e152–6. 10.1097/MJT.0b013e3181f62947 - DOI - PubMed
    1. Aziz M, Fatima R, Mohy-ud-din N, Pervez A, Rastogi A. Endoscopic cyst esophagostomy using a lumen-apposing stent for a large mediastinal pancreatic pseudocyst compressing the left atrium. ACG Case Rep J. (2019) 6:e00016. 10.14309/crj.0000000000000016 - DOI - PMC - PubMed
    1. Matsusue E, Fujihara Y, Maeda K, Okamoto M, Yanagitani A, Tanaka K, et al. Three cases of mediastinal pancreatic pseudocysts. Acta Radiol Open. (2016) 5:2058460116647213. 10.1177/2058460116647213 - DOI - PMC - PubMed

Publication types

LinkOut - more resources