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Pericardial cysts rarely arise from the ascending aorta. We present a case of a 56-year-old male with chronic cough for one month. A mass-like lesion located between the superior vena cava and the ascending aorta was identified by chest radiography. Based on presurgical computed tomographic scanning, the mass was characterized as a well-defined cys-tic lesion with clear contents that appeared to connect to the pericardial cavity through the ascending aorta (size, 5 × 4 × 3 cm). The mass was totally removed with use of a video-assisted thoracoscopic surgical approach. The histology report confirmed that the lesion was a typical pericardial cyst. The patient was discharged three days after the opera-tion; there was no evidence of recurrence after more than six months of follow-up.

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