Magnetic Resonance Imaging and Video-Assisted Thoracoscopy Facilitate the Comprehensive Management of a Large Pericardial Cyst

Background: Pericardial cysts are rare benign mediastinal masses and are often incidental findings on chest imaging. However, patients may present with symptoms that warrant surgical resection. Case Summary: A 47-year-old man presented with progressive dyspnea, cough, and chest tightness. Chest computed tomography revealed a 2.6 × 7.0 × 5.5-cm pericardial cyst anterior to the apical right ventricle. He underwent successful resection using video-assisted thoracoscopy. He recovered well, was discharged on postoperative day 2, and symptoms had fully resolved at his 3-week follow-up visit. Discussion: This case highlights a safe and effective minimally invasive management option for pericardial cysts. Facilitated by thorough preoperative cardiological and radiological workup, video-assisted thoracoscopic surgery facilitates complete resection with rapid postoperative recovery. Take-Home Messages: Pericardial cysts should be included in differential diagnoses for chronic cough and can easily be identified on computed tomography/magnetic resonance imaging. Video-assisted thoracoscopic surgery offers a safe, cost-effective, and reliable method of resection.