Acute shortness of breath due to reoccurrence of an intrapericardial bronchogenic cyst.

A 71-year-old woman presented with dysphagia and acute shortness of breath. Surgical history included a prior thoracotomy overseas for a bronchogenic mesothelial cyst 19 years before. Computed tomography demonstrated a mass within the posterior mediastinum measuring 69 × 70 × 74 mm. A median sternotomy was performed, and after removal of the cyst, repair of the left atrium and pulmonary vessels was undertaken due to the invading nature of the cyst. Intrapericardial bronchogenic cysts are a rare form of congenital cysts arising from the primitive foregut. The cardiac primordia are in close proximity to the foregut and primitive tracheobronchial tree, and thus, abnormal budding of the tracheobronchial tree can arise in a myocardial location. Irrespective of the method of approach in redo surgery, complete resection must be performed in order to minimize the chance of recurrence, relieve symptoms, eliminate risk of infection, and prevent malignant degeneration.