Introduction: Cystic lesions within the pericardial space are a rare entity and comprise 7% of the mediastinal masses and 33% of mediastinal cysts. The reported incidence of pleuropericardial cyst is 1 in 1,00,000 population and most cases are detected incidentally. Most cases are congenital and asymptomatic but life threatening complications may occur in the course of disease. Case Report: A 60 year old male pt. came to our hospital with chief complains of chronic cough, chest pain, dyspnoea , palpitation, a feeling of retrosternal pressure and right shoulder discomfort radiating to right arm since 2 months. Chest X-ray showed e/o isolated cystic shadow in right mediastinum. Patient was advised surgery and underwent Anterior Thoracotomy and excision of cyst. Discussion: Patients with pleuropericardial cysts are usually asymptomatic (up to 60-75% cases). Symptoms usually appear when the cyst compresses on a nearby structure. Common symptoms include chronic cough, chest pain, dyspnoea and a feeling of retrosternal pressure. Conclussion: Pleuropericardial cyst occurs rarely, is clinically silent in majority of cases but can cause life threatening complications. Therefore it is prudent to keep such anomalies in mind when evaluating patients from third and fourth decade of life either during routine health check-up or when such patients present with chest complaints.

Keywords: Pleuropericardial cyst; mediastinum; chronic cough; chest pain; dyspnoea; retrosternal pressure.