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Malik A, Naseer QA, Iqbal MA, Han SY, Dang SC. Retroperitoneal bronchogenic cyst: A case report and review of literature. World J Clin Cases 2024; 12:2586-2596. [PMID: 38817216 PMCID: PMC11135439 DOI: 10.12998/wjcc.v12.i15.2586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 02/28/2024] [Accepted: 04/07/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Bronchogenic cysts are rare developmental anomalies that belong to the category of congenital enterogenous cysts. They arise from lung buds and are present at birth. The embryonic foregut is their origin. Typically, they are located within the chest cavity, particularly in the cavum mediastinale of the thoracic cavity or lodged in the pulmonary parenchyma, and are considered a type of lung bud malformation. CASE SUMMARY A 49-year-old male patient was admitted to the hospital due to the detection of a retroperitoneal mass during a physical examination. Two weeks before admission, the patient underwent a physical examination and routine laboratory tests, which revealed a space-occupying mass in the retroperitoneal region. The patient did not report any symptoms (such as abdominal pain, flatulence, nausea, vomiting, high fever, or chills). The computed tomography (CT) revealed a retroperitoneal space-occupying lesion with minimal enhancement and a CT value of approximately 36 Hounsfield units. The lesion was not delineated from the boundary of the pancreatic body and was closely related to the retroperitoneum locally. CONCLUSION Following a series of tests, an abdominal mass was identified, prompting the implementation of a laparoscopic retroperitoneal mass excision procedure. During the investigation, an 8 cm × 7 cm cystic round-shaped mass with a distinct demarcation was identified in the upper posterior region of the pancreas. Subsequently, full resection of the mass was performed. Postoperative pathological examination reveled a cystic mass characterized by a smooth inner wall. The cystic mass was found to contain a white, viscous liquid within its capsule.
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Affiliation(s)
- Abdul Malik
- Department of General Surgery, The Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
- Department of Preventive Medicine and Public Health Laboratory Science, School of Medicine, Jiangsu University, Zhenjiang 212013, Jiangsu Province, China
| | - Qais Ahmad Naseer
- Department of General Surgery, The Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
- Department of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang 212013, Jiangsu Province, China
| | - Muhammad Asad Iqbal
- Department of General Surgery, The Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Shi-Ya Han
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang 110000, Liaoning Province, China
| | - Sheng-Chun Dang
- Department of General Surgery, The Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
- Department of Surgery, Siyang Hospital, Suqian 223700, Jiangsu Province, China
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Xie W, Huang Z, Huang Z, Chen Z, Zhang B, Xie L, Zhu L, Lian K, Lin D. Retroperitoneal bronchogenic cyst with fluid‑fluid level: A case report and literature review. Exp Ther Med 2022; 25:5. [PMID: 36561609 PMCID: PMC9748708 DOI: 10.3892/etm.2022.11703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/20/2022] [Indexed: 11/18/2022] Open
Abstract
Bronchogenic cyst is a benign lesion with congenital dysplasia. Although the occurrence of this type of cyst is rare in the retroperitoneum, the presence of fluid-fluid levels is an even rarer phenomenon in bronchogenic cysts. Therefore, it can be easily misdiagnosed due to the lack of a universal guideline of specific imaging manifestations. The present report describes the case of a patient with a bronchogenic cyst with fluid-fluid levels whilst also performing a brief literature review to summarize the findings of previous reports on this condition. A 48-year-old male individual presented with severe lower back pain without any obvious causes. A CT scan revealed a low-density cystic mass of ~3x4x6 cm in the left front of the T12-L2 area, which originated from the left crus of the diaphragm. MRI revealed a fluid-fluid level in the cyst. Anterior thoracolumbar surgery was performed to completely resect the mass. During the surgery, it was confirmed that the cyst originated from the left crus of the diaphragm and the lesion was diagnosed to be a bronchogenic cyst by pathological analysis. The patient's symptoms improved after the surgery and no recurrence of the cyst was observed during the 3-year follow-up period. The presence of a fluid-fluid level in a retroperitoneal bronchogenic cyst is rare, particularly in the abdominal aorta and paravertebral regions, rendering it easily misdiagnosed. It may be associated with protein, hemorrhage and calcium-containing mucus deposition in the cysts. In the present study, a rare case of fluid-fluid level in bronchogenic cyst was reported and a literature review was provided.
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Affiliation(s)
- Wei Xie
- Department of Orthopaedics, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou, Fujian 363000, P.R. China
| | - Zemao Huang
- Department of Orthopaedics, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou, Fujian 363000, P.R. China
| | - Ziyang Huang
- Department of Orthopaedics, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou, Fujian 363000, P.R. China
| | - Zhangxin Chen
- Department of Orthopaedics, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou, Fujian 363000, P.R. China
| | - Benjie Zhang
- Department of Orthopaedics, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou, Fujian 363000, P.R. China
| | - Li Xie
- Department of Orthopaedics, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou, Fujian 363000, P.R. China
| | - Lingqi Zhu
- Department of Orthopaedics, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou, Fujian 363000, P.R. China
| | - Kejian Lian
- Department of Orthopaedics, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou, Fujian 363000, P.R. China
| | - Dasheng Lin
- Department of Orthopaedics, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou, Fujian 363000, P.R. China,Correspondence to: Dr Dasheng Lin, Department of Orthopaedics, The 909th Hospital, School of Medicine, Xiamen University, 269 Zhanghua Road, Zhangzhou, Fujian 363000, P.R. China
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Li H, Xu J, Feng Q, Cai Z, Li J. Case report: The safety of laparoscopic surgery for the retroperitoneal bronchogenic cyst. Front Oncol 2022; 12:1011076. [PMID: 36313713 PMCID: PMC9597882 DOI: 10.3389/fonc.2022.1011076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Bronchogenic cyst is a congenital aberration of bronchopulmonary malformation with bronchial-type, pseudostratified cylindrical epithelium. They are usually discovered in the mediastinum and intrapulmonary but are rarely encountered in retroperitoneum. We report a case of the retroperitoneal bronchogenic cyst and perform a literature review to summarize the safety of laparoscopic resection for this rare disease. Case presentation We report a 57-year-old woman who was admitted to our hospital with no clinical symptoms and was found by chance to have masses in the adrenal gland area during a routine physical examination. An abdominal CT examination revealed a cystic lesion was found in the left suprarenal region. Afterward, the patient underwent a laparoscopic exploration. Histopathological findings confirmed the diagnosis of a retroperitoneal bronchogenic cyst. The patient recovered uneventfully without signs of recurrence during a 1-year follow-up period. Conclusion Bronchogenic cyst is rare in the retroperitoneal region. It should be considered as one of the differential diagnoses of a retroperitoneal neoplasm, especially in the left retroperitoneal region. Laparoscopic surgery is technically feasible and safe for the treatment of patients with a retroperitoneal bronchogenic cyst.
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Affiliation(s)
- Hancong Li
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Xu
- Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, China
- Department of Minimal Invasive Surgery, Shangjin Nanfu Hosptial, Chengdu, China
| | - Qingbo Feng
- Department of Liver Surgery and Liver Transplantation Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Zhaolun Cai
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jiaxin Li
- Department of Liver Surgery and Liver Transplantation Centre, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Jiaxin Li,
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Xiao J, Zhang X, Zhou H, Hong T, Li B, He X, Liu W. Subdiaphragmatic bronchogenic cysts: Case series and literature review. Front Med (Lausanne) 2022; 9:993091. [PMID: 36275826 PMCID: PMC9581013 DOI: 10.3389/fmed.2022.993091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/12/2022] [Indexed: 12/01/2022] Open
Abstract
Bronchogenic cysts are congenital malformations caused by aberrant foregut budding. They major occur in the thorax, with subdiaphragmatic cases being uncommon. Here, we present a series of 19 patients diagnosed with subdiaphragmatic bronchogenic cysts histopathologically at a single institution in China from 2012 to 2021. A literature review was also conducted by searching the PubMed database using keywords related to “bronchogenic cysts” and “subdiaphragmatic,” yielding 107 cases. Taken together, the 126 cases had a median age of 41.0 years (interquartile range, 30.0–51.0 years) and 62 of them were male (49.2%). The cysts were most commonly detected in the left adrenal region (36.2%), followed by the pancreatic region (11.5%) and gastric cardia/lesser curvature of the stomach (9.2%). All patients except two underwent surgery for a definite diagnosis, symptom alleviation, and (or) malignancy prevention. Most patients recovered fast and were discharged from the hospital within 1 week after surgery, and the surgical complications were infrequent. The prognosis was generally favorable, as no recurrence was reported during the follow-up as long as 77 months.
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Affiliation(s)
- Jianchun Xiao
- Department of General Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Xueyang Zhang
- Tsinghua University School of Medicine, Beijing, China
| | - Hongru Zhou
- Department of General Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Tao Hong
- Department of General Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Binglu Li
- Department of General Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Xiaodong He
- Department of General Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Wei Liu
- Department of General Surgery, Peking Union Medical College Hospital, Beijing, China,*Correspondence: Wei Liu,
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Murakami T, Shimizu H, Yamazaki K, Nojima H, Usui A, Kosugi C, Shuto K, Obi S, Sato T, Yamazaki M, Koda K. Intra-abdominal ectopic bronchogenic cyst with a mucinous neoplasm harboring a GNAS mutation: A case report. World J Clin Cases 2022; 10:8709-8717. [PMID: 36157792 PMCID: PMC9453374 DOI: 10.12998/wjcc.v10.i24.8709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/23/2022] [Accepted: 07/17/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Bronchogenic cysts are congenital cysts caused by abnormal sprouting from the ventral foregut during fetal life. They usually occur in the mediastinum or lung, but there are very rare cases of ectopic bronchogenic cysts that develop in the abdominal cavity. A unique intra-abdominal ectopic bronchogenic cyst with a mucinous neoplasm that was producing carcinoembryonic antigen (CEA), harboring a GNAS mutation, is reported. The present case may contribute to clarifying the mechanism of tumorigenesis and malignant transformation of ectopic bronchogenic cysts.
CASE SUMMARY In 2007, a man in his 50s was incidentally found to have an intra-abdominal cystic mass, 8 cm in diameter. Surgical resection was recommended, but he preferred to remain under observation. In 2020, his serum CEA level increased to 26.7 ng/mL, and abdominal computed tomography showed a 15 cm × 12 cm, multifocal, cystic mass located predominantly on the lesser curvature of the stomach. Since malignancy could not be ruled out, he finally underwent surgical resection. Histologically, the cystic wall was lined by ciliated columnar epithelium, accompanied by bronchial gland-like tissue, bronchial cartilage, and smooth muscle. Part of the cyst consisted of atypical columnar epithelium with an MIB-1 index of 5% and positive for CEA. Moreover, a GNAS mutation (p.R201C) was detected in the atypical epithelium, leading to a diagnosis of an ectopic bronchogenic cyst with a low-grade mucinous neoplasm. The patient is currently undergoing outpatient follow-up without recurrence.
CONCLUSION An extremely rare case of an abdominal bronchogenic cyst with a low-grade mucinous neoplasm harboring a GNAS mutation was reported.
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Affiliation(s)
- Takashi Murakami
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Chiba, Japan
| | - Hiroaki Shimizu
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Chiba, Japan
| | - Kazuto Yamazaki
- Department of Pathology, Teikyo University Chiba Medical Center, Ichihara 299-0111, Chiba, Japan
| | - Hiroyuki Nojima
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Chiba, Japan
| | - Akihiro Usui
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Chiba, Japan
| | - Chihiro Kosugi
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Chiba, Japan
| | - Kiyohiko Shuto
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Chiba, Japan
| | - Shuntaro Obi
- Department of Internal Medicine, Teikyo University Chiba Medical Center, Ichihara 299-0111, Chiba, Japan
| | - Takahisa Sato
- Department of Internal Medicine, Teikyo University Chiba Medical Center, Ichihara 299-0111, Chiba, Japan
| | - Masato Yamazaki
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Chiba, Japan
| | - Keiji Koda
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Chiba, Japan
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Yuan K, Shu M, Ma Y, Feng W, Ye J, Yuan Y. Ectopic bronchogenic cyst in the retroperitoneal region: a case report and literature review of adult patients. BMC Surg 2021; 21:347. [PMID: 34544401 PMCID: PMC8454181 DOI: 10.1186/s12893-021-01341-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/06/2021] [Indexed: 12/18/2022] Open
Abstract
Background Bronchogenic cyst is congenital aberration of bronchopulmonary malformation, which is rarely encountered in the abdomen and retroperitoneum. We present a case report and literature review of retroperitoneal bronchogenic cyst. Case presentation A 53-year-old female presented to outpatient clinic for a routine checkup of lumbar intervertebral disc herniation. She received a contrast computed tomography scan of the abdomen which revealed a retroperitoneal cystic lesion below the left crura of diaphragm. Afterward, the patient underwent a laparoscopic excision of the cystic lesion and was discharged uneventfully at postoperative day 4. Histopathological findings confirmed the diagnosis of retroperitoneal bronchogenic cyst. Our literature review identified 55 adult cases in recent two decades. The average age at diagnosis was 43.2 (range 17–69) years. 44 (80%) cases had a retroperitoneal cyst on the left side, and 52 (94.5%) cases underwent curative excision through open or laparoscopic surgery. In the available follow up of cases, there was no recurrence after surgery. Conclusions Bronchogenic cyst is rare in the retroperitoneal region. It should be considered as one of the differential diagnoses of a retroperitoneal neoplasm.
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Affiliation(s)
- Kaitao Yuan
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58 2nd Zhongshan Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Man Shu
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Yan Ma
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58 2nd Zhongshan Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Weidong Feng
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58 2nd Zhongshan Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Jinning Ye
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58 2nd Zhongshan Road, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Yujie Yuan
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58 2nd Zhongshan Road, Guangzhou, 510080, Guangdong Province, People's Republic of China.
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Wen Y, Chen W, Chen J, He X. Retroperitoneal bronchogenic cyst resembling an adrenal tumor: two case reports and literature review. J Int Med Res 2021; 48:300060520925673. [PMID: 32436418 PMCID: PMC7243399 DOI: 10.1177/0300060520925673] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Bronchogenic cysts are primitive, foregut-derived developmental anomalies with bronchial-type, pseudostratified cylindrical epithelium. They are usually discovered in the thorax. The occurrence of such cysts in the retroperitoneum is extremely rare. Imaging techniques are generally effective in the detection of retroperitoneal bronchogenic cyst. Here, we report two cases (a 27-year-old man and a 33-year-old man) who had no clinical symptoms and were found by chance to have masses in the adrenal gland area during routine physical examination. We found that they had some similar computed tomography imaging features, including complete adrenal structure, cystic fusiform mass in adrenal region, and inclusion of calcifications in the lesions. However, accurate preoperative diagnosis remains difficult and only histology can provide a definitive diagnosis. Surgery remains the treatment of choice.
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Affiliation(s)
- Yang Wen
- Department of Radiology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Wanyuan Chen
- Department of Pathology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Junfa Chen
- Department of Radiology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Xiaodong He
- Department of Radiology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
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Cassiani J, Crinò SF, Manfrin E, Rivelli M, Gabbrielli A, Guglielmi A, Pedrazzani C. Endoscopic Ultrasound Through-the-Needle Biopsy for the Diagnosis of an Abdominal Bronchogenic Cyst. Clin Endosc 2021; 54:767-770. [PMID: 33596637 PMCID: PMC8505176 DOI: 10.5946/ce.2020.195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/17/2020] [Indexed: 01/01/2023] Open
Abstract
A 57-year-old woman with epigastric pain was diagnosed with a 6-cm abdominal cystic lesion of unclear origin on cross-sectional imaging. Endoscopic ultrasound (EUS) demonstrated a unilocular cyst located between the pancreas, gastric wall, and left adrenal gland, with a regular wall filled with dense fluid with multiple hyperechoic floating spots. A 19-G needle was used to puncture the cyst, but no fluid could be aspirated. Therefore, EUS-guided through-the-needle biopsy (EUS-TTNB) was performed. Histological analysis of the retrieved fragments revealed a fibrous wall lined by "respiratory-type" epithelium with ciliated columnar cells, consistent with the diagnosis of a bronchogenic cyst. Laparoscopic excision was performed, and the diagnosis was confirmed based on the findings of the surgical specimen. Abdominal bronchogenic cysts are extremely uncommon, and a definitive diagnosis is commonly obtained after the examination of surgical specimens due to the lack of pathognomonic findings on cross-sectional imaging and poor cellularity on EUS-guided fine-needle aspiration cytology. EUS-TTNB is useful for establishing a preoperative histological diagnosis, thus supporting the decision-making process.
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Affiliation(s)
- Jessica Cassiani
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Unit of General and Hepatobiliary Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy
| | - Stefano Francesco Crinò
- Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona Hospital Trust, University of Verona, Verona, Italy
| | - Erminia Manfrin
- Department of Diagnostic and Public Health, University of Verona Hospital Trust, University of Verona, Verona, Italy
| | - Matteo Rivelli
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Unit of General and Hepatobiliary Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy
| | - Armando Gabbrielli
- Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona Hospital Trust, University of Verona, Verona, Italy
| | - Alfredo Guglielmi
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Unit of General and Hepatobiliary Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy
| | - Corrado Pedrazzani
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Unit of General and Hepatobiliary Surgery, University of Verona Hospital Trust, University of Verona, Verona, Italy
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A case report- retroperitoneal bronchogenic cyst in relation to the hindgut. Int J Surg Case Rep 2020; 75:140-142. [PMID: 32950943 PMCID: PMC7508688 DOI: 10.1016/j.ijscr.2020.09.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/15/2020] [Accepted: 09/05/2020] [Indexed: 12/21/2022] Open
Abstract
Bronchogenic cysts are rare primitive foregut derived developmental aberrations in early embryonic life. Typically occur in the mediastinum. They arise from an abnormal budding of the tracheobronchial anlage. A Retroperitoneal location of bronchogenic cysts is exceptionally unusual. They are mostly asymptomatic. Due to continued epithelial secretion, these lesions have a tendency to become larger as the patients get older.
Introduction Bronchogenic cysts are developmental anomalies which occur as an abnormal budding of the primitive foregut or tracheobronchial tree. Bronchogenic cysts arise most often in the mediastinum. They can occur in many atypical locations. A retroperitoneal location is exceptionally unusual. Presentation of case We present the case of a 46-year-old male with complaints of dyspeptic symptoms, who, on routine evaluation was found to have a mass in the Left iliac fossa. The patient’s past medical and surgical history is unremarkable and had no history of trauma. The patient’s clinical examination was unremarkable except for mild tenderness in the Left iliac fossa. Routine Pre-operative Blood investigations were within normal limits. Computed Tomography showed 4 × 3.4 cm lesion on the anterior surface of the left psoas muscle just abutting the left ureter. A colonoscopy done revealed normal study. The tumour was excised in-toto through a retroperitoneal approach. Discussion Bronchogenic cysts are rare primitive foregut derived developmental aberrations in early embryonic life, typically occurring in the mediastinum. They arise from an abnormal budding of the tracheobronchial anlage of the primitive foregut between the 3rd and 7th weeks of development. Retroperitoneal bronchogenic cysts occur almost equally in men and women. CT and MRI are found to be ideal imaging modalities Surgical resection of these lesions is recommended. Laparoscopic surgery is preferred. Only one case of a retroperitoneal bronchogenic cyst associated with the development of adenocarcinoma has been reported. Conclusion The differential can be kept in mind when incidentally detected cysts are found during diagnostic imaging for other symptoms.
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10
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Intraabdominal bronchogenic cyst. Dig Liver Dis 2020; 52:784-785. [PMID: 32456853 DOI: 10.1016/j.dld.2020.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 12/11/2022]
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García-Romera Á, Tuñón-Féquant C, Díaz-Pérez B, Bravo-Gutiérrez A, Alarcó-Hernández A. Retrorectal Broncogenic Cyst. Cir Esp 2020; 99:157-159. [PMID: 32507500 DOI: 10.1016/j.ciresp.2020.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Ángel García-Romera
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España.
| | - Carlota Tuñón-Féquant
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España
| | - Beatriz Díaz-Pérez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España
| | - Alberto Bravo-Gutiérrez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España
| | - Antonio Alarcó-Hernández
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España
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Matsuda H, Ishida M, Miyasaka C, Michiura T, Inoue K, Sekimoto M, Tsuta K. Intramural bronchogenic cysts of the esophagus and gastroesophageal junction: A case report. Mol Clin Oncol 2020; 13:162-168. [PMID: 32714540 PMCID: PMC7366213 DOI: 10.3892/mco.2020.2058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 05/19/2020] [Indexed: 11/06/2022] Open
Abstract
Bronchogenic cyst is a relatively rare congenital malformation that is often identified in the mediastinum. The occurrence of bronchogenic cysts in the intramural esophagus and gastroesophageal junction is rare. The present report describes three cases of intramural bronchogenic cysts of the esophagus and gastroesophageal junction and reviews the clinicopathological features of these lesions. A 35-year-old Japanese male (Case 1), a 50-year-old Japanese woman (Case 2) and a 34-year-old Japanese man (Case 3) presented with dysphagia, pharyngeal pain and heartburn, respectively. Upper endoscopic examination revealed submucosal tumors in the esophagus (Case 1 and 2) and gastroesophageal junction (Case 3). Subsequent endoscopic examination revealed perforation of the cyst into the surface of the esophageal mucosa (Case 2). Surgical resection was performed in all cases. Histopathological examinations revealed that the submucosal cysts were covered by respiratory-type ciliated epithelium without atypia. Cartilage and bronchial glands were not observed in any of the cases. The present review of the clinicopathological characteristics of bronchogenic cysts of the esophagus and gastroesophageal junction revealed that males and females were equally affected. The median age of the patients was 34.5 years with a wide age distribution. The most common main complaint was dysphagia. A pre-operative diagnosis of bronchogenic cyst is difficult because no specific imaging features are present. As surgical resection is recommended for this lesion, recognition of the clinicopathological features of bronchogenic cysts is important for an accurate pre-operative diagnosis.
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Affiliation(s)
- Hayato Matsuda
- Department of Pathology and Laboratory Medicine, Hirakata, Osaka 573-1010, Japan
| | - Mitsuaki Ishida
- Department of Pathology and Laboratory Medicine, Hirakata, Osaka 573-1010, Japan
| | - Chika Miyasaka
- Department of Pathology and Laboratory Medicine, Hirakata, Osaka 573-1010, Japan
| | - Taku Michiura
- Department of Surgery, Kansai Medical University, Hirakata, Osaka 573-1010, Japan
| | - Kentaro Inoue
- Department of Surgery, Kansai Medical University, Hirakata, Osaka 573-1010, Japan
| | - Mitsugu Sekimoto
- Department of Surgery, Kansai Medical University, Hirakata, Osaka 573-1010, Japan
| | - Koji Tsuta
- Department of Surgery, Kansai Medical University, Hirakata, Osaka 573-1010, Japan
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13
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Cheng Y, Chen D, Shi L, Yang W, Sang Y, Duan S, Chen Y. Surgical treatment of an esophageal bronchogenic cyst with massive upper digestive tract hematoma without esophagectomy: a case report and the review of the literature. Ther Clin Risk Manag 2018; 14:699-707. [PMID: 29765221 PMCID: PMC5939876 DOI: 10.2147/tcrm.s153145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Esophageal bronchogenic cysts are extremely rare. Here we report a case of massive upper digestive tract hematoma and bronchogenic cyst mimicking aortic dissection that was safely removed without esophagectomy. A 30-year-old man was referred to our hospital for the treatment of a mediastinal cystic tumor located in the submucosa of the distal esophagus. His chief complaints were dysphagia > 1 week and severe persistent upper abdominal pain mimicking aortic dissection with constant vomiting for 1 day after gastroscopy examination. The serum level of carbohydrate antigen (CA)199 was > 1,000 U/mL and CA125 was 4,816 U/mL. Hemoglobin levels decreased from 122 g/L to 85 g/L in 5 days. Imaging examinations detected a huge hematoma of the gastric wall. Preoperative diagnosis was difficult. Although the pain indicated a possible aortic dissection, the abnormal levels of tumor biomarkers suggested malignancy. The patient underwent left thoracotomy. The cyst showed an exophytic lesion connected to the esophageal wall at the level of the gastroesophageal junction. Muddy brown contents were obtained by aspiration of the mass intraoperatively. Because enucleation could not be performed, esophageal myotomy in the distal esophagus and partial resection of the cyst were selected. Histopathological examination indicated a bronchogenic cyst of the esophagus. At a follow-up visit 3 months later, the patient had no signs of disease recurrence or any complaints. Postoperative tumor biomarkers returned to normal range. The present report summarizes the clinical details of the case and reviews the literature in order to improve the accuracy of diagnosis.
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Affiliation(s)
- Yuanjun Cheng
- Department of Cardiothoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Donglai Chen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Li Shi
- Department of Cardiothoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Wentao Yang
- Department of Cardiothoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yonghua Sang
- Department of Cardiothoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Shanzhou Duan
- Department of Cardiothoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yongbing Chen
- Department of Cardiothoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
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Byers JT, Gertz HE, French SW, Wang L. Case report: Retroperitoneal bronchogenic cyst as a diagnostic dilemma after colon cancer diagnosis. Exp Mol Pathol 2018; 104:158-160. [PMID: 29452079 DOI: 10.1016/j.yexmp.2018.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 02/12/2018] [Indexed: 01/18/2023]
Abstract
A 52 year-old obese male presented with a moderately differentiated adenocarcinoma of the sigmoid colon. On staging CT, the patient was found to have a cystic lesion in the left retroperitoneum.
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Affiliation(s)
- Joshua T Byers
- Harbor-UCLA, Department of Pathology, 1000 W. Carson St., Torrance, CA 90509, United States.
| | - Henning E Gertz
- Harbor-UCLA, Department of Pathology, 1000 W. Carson St., Torrance, CA 90509, United States.
| | - Samuel W French
- Harbor-UCLA, Department of Pathology, 1000 W. Carson St., Torrance, CA 90509, United States.
| | - Lina Wang
- Harbor-UCLA, Department of Pathology, 1000 W. Carson St., Torrance, CA 90509, United States.
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15
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Pasquer A, Djeudji F, Hervieu V, Rabeyrin M, Barth X. A rare retrorectal presentation of a bronchogenic cyst: A case report. Int J Surg Case Rep 2016; 24:112-4. [PMID: 27236578 PMCID: PMC4887582 DOI: 10.1016/j.ijscr.2016.05.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 05/10/2016] [Accepted: 05/10/2016] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Bronchogenic cysts are rare abnormalities and a retrorectal presentation is exceptional. Its natural history is not known, but malignant transformation is quite rare. Retrorectal bronchogenic cysts are usually asymptomatic. PRESENTATION OF THE CASE We present the case of a 36-year-old young man with a past medical history of HIV seropositivity who underwent a procedure to excise a sacral coccyx cyst at another surgical center in February 2009. A histological examination confirmed it was a sacral cyst that was resected in sano. The patient presented with a recurrence of the cyst, and this report describes the combined surgical procedure using a double sacrococcygeal and abdominal approach. DISCUSSION A complete excision without cyst rupture is recommended to reduce the risk of local recurrence and malignant transformation, as previously reported. Resection can ben performed using multiple approaches depending on the cyst's location CONCLUSION Herein, we report the case of a retrorectal bronchogenic cyst in a 36 years old man who was initially treated for a pilonidal cyst. A double surgical approach (abdominal and Kraske) resulted in complete resectioning with no reccurrence.
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Affiliation(s)
- Arnaud Pasquer
- Department of Digestive and Colorectal Surgery, Edouard Herriot University Hospital, Lyon, France.
| | - Filbert Djeudji
- Department of Digestive and Colorectal Surgery, Edouard Herriot University Hospital, Lyon, France
| | - Valérie Hervieu
- Department of Anatomopathology, Edouard Herriot University Hospital, Lyon, France; University Claude Bernard Lyon I, 8 Avenue Rockefeller, Lyon, France
| | - Maud Rabeyrin
- Department of Anatomopathology, Edouard Herriot University Hospital, Lyon, France
| | - Xavier Barth
- Department of Digestive and Colorectal Surgery, Edouard Herriot University Hospital, Lyon, France; University Claude Bernard Lyon I, 8 Avenue Rockefeller, Lyon, France
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16
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Tonouchi A, Kinoshita T, Sunagawa H, Hamakawa T, Kaito A, Shibasaki H, Kuwata T, Seki Y, Nishida T. Bronchogenic cyst at esophagogastric junction treated by laparoscopic full-thickness resection and hand-sewn closure: a case report. Surg Case Rep 2016; 2:41. [PMID: 27117265 PMCID: PMC4848280 DOI: 10.1186/s40792-016-0168-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 04/21/2016] [Indexed: 12/21/2022] Open
Abstract
Background We herein report a case of a bronchogenic cyst arising from the esophagogastric junction treated by laparoscopic full-thickness extirpation. The full-thickness defect was closed by hand sewing a T-shaped line over the gastroendoscope as a bougie to prevent postoperative deformity or stenosis. Partial fundoplication (Toupet fundoplication) was added to prevent reflux. Case presentation A 32-year-old woman with a body mass index of 43 kg/m2 was admitted for treatment of a cyst-forming submucosal tumor (60 mm in diameter) on the anterior wall of the esophagogastric junction, which was detected during screening endoscopy before bariatric surgery. The tumor was an extraluminal growing type but exhibited severe erosion at the mucosal site. A cystic tumor such as a duplication cyst, bronchogenic cyst, or cyst-forming gastrointestinal stromal tumor was suspected, and the abovementioned surgery was carried out. The postoperative course was uneventful. The pathological findings revealed the tumor to be a benign bronchogenic cyst. Endoscopic examination 3 months postoperatively showed no deformity or stenosis, and the patient complained of no reflux symptoms. Conclusion This procedure may be an efficient option for treatment of submucosal tumors on the esophagogastric junction to maintain function or avoid excessive surgery.
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Affiliation(s)
- Akiko Tonouchi
- Gastric Surgery Division, National Cancer Centre Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Takahiro Kinoshita
- Gastric Surgery Division, National Cancer Centre Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
| | - Hideki Sunagawa
- Gastric Surgery Division, National Cancer Centre Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Takuya Hamakawa
- Gastric Surgery Division, National Cancer Centre Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Akio Kaito
- Gastric Surgery Division, National Cancer Centre Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Hidehito Shibasaki
- Gastric Surgery Division, National Cancer Centre Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Takeshi Kuwata
- Pathological Division, National Cancer Centre Hospital East, Kashiwa, Japan
| | - Yosuke Seki
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Toshirou Nishida
- Gastric Surgery Division, National Cancer Centre Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
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17
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Tu C, Zhu J, Shao C, Mao W, Zhou X, Lin Q, Li Z, Zhang J, Zhou Q, Chen W. Gastric bronchogenic cysts: A case report and literature review. Exp Ther Med 2016; 11:1265-1270. [PMID: 27073434 PMCID: PMC4812213 DOI: 10.3892/etm.2016.3067] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 01/29/2016] [Indexed: 12/11/2022] Open
Abstract
Gastric bronchogenic cysts are rare lesions, first described in 1956, with only 34 cases reported in the literature to date. The present study described a case of bronchogenic cyst of the stomach in a 17-year-old female who presented with periodic epigastric pain. In addition, the study analyzed the existing literature on these lesions. Gastric bronchogenic cysts are more common in females (female:male ratio, 21:14) and the median age of their development is 43 years. In total, 48.57% of the 34 previously reported cases were identified incidentally, and the remainder presented mainly with epigastric pain. Cyst sizes varied between 1.7 and 15 cm. In 3 cases, preoperative diagnosis was performed using needle biopsy, whereas several studies were initially misdiagnosed as stromal tumors. In 85% of the cases (31/35), cyst resection was performed, with laparoscopy used in 4 of the cases. The findings of the present study and literature review suggested that bronchogenic cysts of the stomach are rare, and surgical resection is warranted to treat symptoms and prevent malignant transformation.
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Affiliation(s)
- Chaoyong Tu
- Department of General Surgery, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Jingde Zhu
- Department of General Surgery, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Chuxiao Shao
- Department of General Surgery, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Weibo Mao
- Department of Pathology, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Xingmu Zhou
- Department of Pathology, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Qiaomei Lin
- Department of General Surgery, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Zhukai Li
- Department of General Surgery, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Jie Zhang
- Department of General Surgery, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Qingyue Zhou
- Department of General Surgery, Lishui Central Hospital, Lishui, Zhejiang 323000, P.R. China
| | - Wei Chen
- Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
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18
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Trehan M, Singla S, Singh J, Garg N, Mahajan A. A Rare Case of Intra- Abdominal Bronchogenic Cyst- A Case Report. J Clin Diagn Res 2015; 9:PD03-4. [PMID: 26675877 DOI: 10.7860/jcdr/2015/12949.6761] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 08/24/2015] [Indexed: 01/03/2023]
Abstract
Bronchogenic cysts are developmental foregut anomalies usually located in the mediastinum. A 90% of the bronchogenic cysts occur in the posterior aspect of superior mediastinum. Retroperitoneal location of a bronchogenic cyst is rare. We report a rare case of intra abdominal bronchogenic cyst. A CT scan was done for a 34-year-old female who presented with complains of heaviness in the right flank. CT scan revealed a large cyst of 10 x 6 cm in the right hypochondrium. Cyst was removed laparoscopically and the histopathology revealed a bronchogenic cyst.
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Affiliation(s)
- Munish Trehan
- Assistant Professor, Department of Surgery, DMCH , Ludhiana, Punjab, India
| | - Sanjeev Singla
- Professor, Department of Surgery, DMCH , Ludhiana, Punjab, India
| | - Jaspal Singh
- Professor and Head, Department of Surgery, DMCH , Ludhiana, Punjab, India
| | - Nikhil Garg
- Resident, Department of Surgery, DMCH , Ludhiana, Punjab, India
| | - Anuj Mahajan
- Resident, Department of Surgery, DMCH , Ludhiana, Punjab, India
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19
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Tong HX, Liu WS, Jiang Y, Liu JU, Zhou JJ, Zhang Y, Lu WQ. Giant retroperitoneal bronchogenic cyst mimicking a cystic teratoma: A case report. Oncol Lett 2015; 9:2701-2705. [PMID: 26137131 DOI: 10.3892/ol.2015.3076] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 02/17/2015] [Indexed: 12/26/2022] Open
Abstract
Retroperitoneal bronchogenic cysts (RBCs) are regarded as a rare type of congenital dysplasia disease that stems from the primitive foregut. Thus far, the exact pathogenesis of RBCs remains unknown. Due to an atypical clinical manifestation, RBCs are often incidentally detected and diagnosed by imaging modalities, such as computed tomography and magnetic resonance imaging. However, they are easily misdiagnosed due to their non-specific imaging features. Additionally, the most appropriate treatment strategy for an RBC is considered to be surgical resection. The present study reports the rare case of a 36-year-old female with a large RBC containing fatty fluid that was previously misdiagnosed as liposarcoma or cystic teratoma. Following a complex surgical resection, pathological findings confirmed a diagnosis of RBC. The follow-up examination showed that the patient was in good health at 16 months post-surgery, with no evidence of recurrence. Although rare, bronchogenic cysts must be considered in the differential diagnosis of retroperitoneal teratoma, and surgical resection should be pursued for symptom resolution and to establish a definitive histology.
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Affiliation(s)
- Han-Xing Tong
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Wen-Shuai Liu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Ying Jiang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - J U Liu
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Jian-Jun Zhou
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Yong Zhang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Wei-Qi Lu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
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20
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Esophageal bronchogenic cyst and review of the literature. Surg Endosc 2015; 29:3010-5. [PMID: 25669636 DOI: 10.1007/s00464-015-4082-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 01/08/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Bronchogenic cysts are rare foregut abnormalities that arise from aberrant budding of the tracheobronchial tree early in embryological development. These cysts predominantly appear in the mediastinum, where they may compress nearby structures. Intra-abdominal bronchogenic cysts are rare. We report an intra-abdominal bronchogenic cyst that was excised laparoscopically. METHODS A 40-year old female with a history of gastritis presented for evaluation of recurrent abdominal pain. A previous ultrasound showed cholelithiasis and a presumed portal cyst. Physical examination and laboratory findings were unremarkable. A CT scan with pancreatic protocol was performed and an intra-abdominal mass adherent to the esophagus was visualized. A laparascopic enucleation of the mass was performed. A 3-cm myotomy was made after circumferential dissection of the cyst and the decision was made intraoperatively to reapproximate the muscularis layer. A PubMed literature search on surgical management of esophageal bronchogenic cysts was subsequently performed. RESULTS The literature search performed on the subject of esophageal bronchogenic cysts found one review article focusing on intramural esophageal bronchogenic cysts in the mediastinum and five case reports of esophageal bronchogenic cysts. Of these, only one was both intraabdominal and managed laparascopically with simple closure of the resulting myotomy. The majority of the bronchogenic cysts mentioned in the literature were located mediastinally and were managed via open thoracotomy. Our findings confirm the rarity of this particular presentation and the unique means by which this cyst was surgically excised. CONCLUSION This case highlights the management of a rare entity and advocates for enucleation of noncommunicating, extraluminal esophageal bronchogenic cysts and closure of the esophageal muscular layers over intact mucosa as a viable surgical approach to this unusual pathology. Other cases of laparascopic enucleation of bronchogenic cysts have shown similarly uneventful postoperative courses and rapid recovery with no apparent return of symptoms.
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21
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Dong B, Zhou H, Zhang J, Wang Y, Fu Y. Diagnosis and treatment of retroperitoneal bronchogenic cysts: A case report. Oncol Lett 2014; 7:2157-2159. [PMID: 24932307 PMCID: PMC4049691 DOI: 10.3892/ol.2014.1974] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 02/20/2014] [Indexed: 12/12/2022] Open
Abstract
Bronchogenic cysts are uncommon, predominantly benign, congenital malformations arising from the primitive foregut. The occurrence of such cysts in the retroperitoneum is extremely rare. The present study presents the case of a 30-year-old female who presented with a left adrenal mass. Imaging investigations revealed a cystic mass located medially to the left adrenal gland. Retroperitoneal laparoscopic excision and complete resection were performed, and the subsequent pathological examination confirmed the diagnosis of a bronchogenic cyst in the retroperitoneum. The patient was discharged on the fourth post-operative day and received no further treatment, however, regular follow-up was performed due to the lesion being benign. A rare case of bronchogenic cyst and literature review is presented, which may aid in improving the understanding of the etiology and pathogenesis of retroperitoneum bronchogenic cysts.
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Affiliation(s)
- Biao Dong
- Department of Urology, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Honglan Zhou
- Department of Urology, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Jianjian Zhang
- Department of Hepatic Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, P.R. China
| | - Yuantao Wang
- Department of Urology, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Yaowen Fu
- Department of Urology, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
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22
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Abstract
Bronchogenic cyst is a relatively rare abnormality that develop from the accessory lung buds of the foregut. The cyst is regarded as a congenital developmental abnormality. Occurence in the retroperitoneal presentation is rare. Here, we present two patients who had an incidentally discovered retroperitoneal mass which were revealed to be bronchogenic cysts after surgical extirpation.
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23
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Bronchogenic cyst of stomach: two cases report and review of the English literature. Wien Klin Wochenschr 2013; 125:283-7. [PMID: 23579880 DOI: 10.1007/s00508-013-0352-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 03/11/2013] [Indexed: 12/17/2022]
Abstract
Bronchogenic cysts (BCs) are a rare clinical entity because of anomalism of foregut in the embryonic stage. They have been described mostly within the mediastinum and are uncommon reported arising from the stomach. In this article, we report two cases of BC of stomach identified by pathological examination after surgical resection. It is extremely difficult to make a definitive diagnosis preoperatively just based on imaging findings. Surgical resection may be indicated if malignancy is suspected, or the cyst is enlarging or infected or causing symptoms.
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Abstract
This is a rare case of a bronchogenic cyst found below the diaphragm within the lesser sac successfully resected by laparoscopic means. Bronchogenic cysts rarely develop in the abdomen they typically reside in the mediastinum. We present a unique case of a bronchogenic cyst within the lesser sac. Endoscopic ultrasound proved to be a critical diagnostic tool, and the patient underwent a laparoscopic resection of the lesion.
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Govaerts K, Van Eyken P, Verswijvel G, Van der Speeten K. A bronchogenic cyst, presenting as a retroperitoneal cystic mass. Rare Tumors 2012; 4:e13. [PMID: 22532911 PMCID: PMC3325740 DOI: 10.4081/rt.2012.e13] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2011] [Accepted: 12/12/2011] [Indexed: 12/13/2022] Open
Abstract
Bronchogenic cysts are mostly benign, congenital abnormalities originating from the remnants of the primitive foregut. A retroperitoneal location is rare. Due to the mostly asymptomatic behavior and the historical confusion regarding histology, an exact prevalence is not known. We present here a case report of a retroperitoneal bronchogenic cyst. A literature review was performed for cases of retroperitoneal bronchogenic cysts written in English. Anatomopathological criteria for inclusion were pseudo stratified, ciliated, columnar epithelium together with the presence of at least one of the following: cartilage, smooth muscle or seromucous glands. In addition, the embryology, pathogenesis, radiological, clinical and suggested treatment modalities are reviewed. We report the surgical excision of a retroperitoneal bronchogenic cyst that presented as a non-functioning left adrenal mass. Our review of literature revealed only 62 potential cases of retroperitoneal bronchogenic cysts. After applying the strict anatomopathological criteria, only 30 cases of true retroperitoneal bronchogenic cysts could be identified. Retroperitoneal location of a bronchogenic cyst is rare. Despite the rarity of this pathologic entity, bronchogenic cysts should be considered in the differential diagnosis of retroperitoneal cystic lesions. Only histology can confirm definitive diagnosis. Surgery remains the recommended treatment of choice.
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Affiliation(s)
- Kim Govaerts
- Department of Surgical Oncology, Ziekenhuis Oost Limburg, Genk, Belgium
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26
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Laparoscopic excision of subdiaphragmatic bronchogenic cyst occurring in the retroperitoneum: report of a case. Surg Laparosc Endosc Percutan Tech 2011; 20:e199-203. [PMID: 21150402 DOI: 10.1097/sle.0b013e3181fcbe92] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Although bronchogenic cysts (BCs) are benign congenital malformations usually occur in thoracic cavity, retroperitoneal location is extremely uncommon. We reported a case of BC occurred in the retroperitoneum, which was excised laparoscopically. A 64-year-old Japanese woman was admitted to the hospital because of submucosal tumor in the upper part of the stomach. An upper gastrointestinal endoscopy revealed a submucosal tumor located just distal to the esophagogastric junction. The abdominal computed tomography scan revealed a cystic mass located in contact with lesser curvature of the stomach and the dorsal surface of the liver. As the cystic mass was well-circumscribed and showed no positive findings suggestive of malignancy, the laparoscopic excision of the cystic mass was performed. The cystic tumor was completely excised with a laparoscopic procedure. The histologic findings indicated that the cyst was surfaced by the ciliated pseudostratified epithelium without the presence of the cartilage, which was compatible with the BC of the retroperitoneum. This case highlights the safety and the feasibility of complete laparoscopic excision of retroperitoneal BC. Laparoscopic excision of retroperitoneal BC definitely provides all advantages of minimally invasive procedure, which improves postoperative patient discomfort and pain and shortens hospital stay. Laparoscopic procedure may definitely be a standard approach for the excision of retroperitoneal BC.
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