Rare Pediatric Venolymphatic Malformations

BACKGROUND: Pericardial cystic masses are rare, and exceedingly so in pediatrics. The clinical course of such masses in children is poorly described. CASE SUMMARY: We report 2 cases in 3- and 7-year-old children. Both were initially thought to represent pericardial cysts on imaging, but surgical excision and histopathology confirmed diagnoses of a venolymphatic malformation and an epicardial cyst, respectively. The first patient presented with abdominal pain, and the second patient was asymptomatic. Both recovered well after an uncomplicated surgical intervention. DISCUSSION: A small number of patients with pericardial masses will have symptoms thought to be related to compression of adjacent organs. Thus, this family of diagnoses must be considered in patients with findings suggestive of a pericardial cyst. TAKE HOME MESSAGES: Fluid-filled pericardial masses in children present a broad differential diagnosis that require comprehensive evaluation. Multidisciplinary decision-making and multimodal imaging were critical to the successful diagnosis and management of these patients.