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The case of a left-sided pericardial cyst (PC) in a 24 year old asymptomatic patient is presented. Review of previous chest X-rays indicated that the PC had developed within five years. The PC could be clearly identified by M-mode echocardiography (E); the pattern, however, was similar to that of a pseudoaneurysm of the left ventricle, the latter being an important differential diagnosis. Computed tomography (CT) showed not only the position and size of the PC but allowed, based on attenuation values, a clear differentiation between a pseudoaneurysm and a cystic structure filled with an aqueous solution. The combined use of E and CT seems to represent a valuable non-invasive tool in the diagnosis of abnormal configurations of the left ventricle. [ABSTRACT FROM PUBLISHER]