CTICasesMetastatic Disease Seeding a Pericardial Cyst
Imaging findings
CT scans in a patient with metastatic breast cancer demonstrate a pre-existing, stable fluid-filled pericardial cyst. Over time, in the setting of progressive systemic metastatic disease, the cyst wall develops new, nodular soft-tissue thickening and enhancing focal deposits, representing tumor metastases seeding the cyst wall (or a seeded pericardial diverticulum).
Key takeaways
While pericardial cysts are benign, congenital fluid-filled structures that rarely change, they can be involved by secondary processes. In patients with advanced metastatic disease, the wall of a pericardial cyst (or a pericardial diverticulum communicating with the pericardial space) can be seeded by hematogenous metastases or direct translocation of tumor cells within the pericardial fluid, mimicking a malignant pericardial tumor.
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