A rare intrapericardial mass in a neonate.

We describe a rare case of a neonate born with an intrapericardial mass composed of extralobar pulmonary sequestration and a cyst of bronchogenic origin. After an uneventful delivery, this full-term newborn was noted to be grunting and indrawing. He remained tachypneic despite adequate management for bilateral pneumothoraces. Diagnostic studies showed a 3 x 3 x 4 cm diameter cystic lesion in the anterior mediastinum causing posterior-lateral displacement of the superior vena cava. The heart itself was structurally normal. Bronchoscopy and esophagoscopy failed to detect any structural abnormalities. At 3 weeks of age, sternotomy and resection of the lesion was performed. The mass was clearly intrapericardial and consisted of sequestrated pulmonary tissue with a unilocular mucus filled bronchogenic cyst. Small systemic tributaries fed the lesion from the posterior-superior aspect. There was no connection with the heart or great vessels. Postoperative recovery was uneventful.