A case of cutaneous bronchogenic cyst over the left scapula

Bronchogenic cyst of the posterior neck mimicking lymphatic malformation

Bronchogenic cysts are embryologic malformations of the foregut and are rarely found head and neck region. Here we present a case of an upper scapular/lower posterior neck cystic mass which was initially suspicious for lymphatic malformation but confirmed by pathology to be an ectopic bronchogenic cyst.

Scapular Bronchogenic Cyst in a Girl Presenting as Recurrent Cellulitis: A Case Report and Review of the Literature

Bronchogenic cysts are rare, congenital cysts originating from respiratory epithelium and typically found within the chest. Cutaneous bronchogenic cysts are exceedingly uncommon, with only 19 reported cases in the scapular region and almost exclusively occurring in male patients. Herein, we present the case of a female patient with recurrent cellulitis secondary to a bronchogenic cyst, which was diagnosed after surgical excision. We also provide a review of the literature to consolidate the current understanding of cutaneous scapular bronchogenic cysts. To our knowledge, this is the first such case reported from Canada.

Cutaneous bronchogenic cyst in the left scapular region of a boy

BACKGROUND

Scapular bronchogenic cyst (SBC) is rare.

METHODS

A sinus on a boy's left scapula was excised.

RESULTS

Histopathological analysis showed the epithelium with scattered PAS-positive goblet cells was positive for CEA and CK7.

CONCLUSION

SBC should be suspected of a superficial scapular skin lesion in children.

Scapular bronchogenic cyst: a case report and literature review

Bronchogenic cysts originate from abnormal budding of the tracheal diverticula during the embryological period. Inaccuracy in the process of growing of the ventral foregut will give rise to bronchogenic cyst. Scapular bronchogenic cyst is an extremely rare form of this anomaly. A three years old boy suffered for 2 years with left sided suprascapular cystic lesion which was gradually increasing in size. The swelling was 4 × 3 cm in size and non tender. The cyst was evaluated by CT scan that showed complex cystic lesion over the left scapular spine. Total excision of the cyst was done and histopathology showed cutaneous bronchogenic cyst. The proposed mechanism for such cutaneous lesion is that the accessory buds from the tracheobronchial tree/primitive foregut migrated from the thorax in an aberrant manner to lie in periscapular positions. The definitive treatment of scapular lesions is total surgical excision. The final diagnosis is based on the histopathological findings in the majority of cases.

Bronchogenic cyst of the shoulder

An 8-month-old girl presented with a painless mass on her left shoulder that was noticed by her mother. Ultrasonography and magnetic resonance imaging (MRI) showed a well-defined subcutaneous cystic mass. The excised cyst was lined with ciliated pseudostratified columnar epithelium with occasional goblet cells and diagnosed as a bronchogenic cyst. She made a good recovery.

A bronchogenic cyst under the scapula with a fistula on the back

A 20-year-old patient with a chronic fistula located at the left scapular region caused by a deep located subscapular bronchogenic cyst is described.

[Cutaneous bronchogenic cyst]

Bronchogenic cysts rarely affect the cutaneous surface, so they are difficult to diagnose clinically and are often confused with other types of cysts. We present the case of a young adult in whom a cystic lesion showing characteristics of a bronchogenic cyst was excised from the upper thorax area. We emphasize the fact that, in nearly all cases, the diagnosis of this pathology is made through a histopathological study, and we make special reference to the differential diagnoses.

Scapular bronchogenic cysts in children: case report and review of the literature

Cutaneous bronchogenic cysts (CBC) are rare solitary lesions which originate from primitive tracheobronchial tree. The periscapular location of these lesions is even a rare condition. The aim of this study is to evaluate this pathology after our case with literature review. An one-year-old girl was brought to our clinics with the complaint of a drainage at the back of her shoulder. In her physical examination, a hyperemic enduration with a sinus and purulent drainage was noted at the left scapular region. Ultrasonography revealed a lesion of 15x11 mm2 in size with a thick wall and a hypoechoic center. The lumen of the cyst was demonstrated with fistulography. Surgical excision of the lesion was performed and pathological examination revealed a cutaneous bronchogenic cyst. CBC have been reported in 64 cases in the literature. They are often found in the lower neck, sternum and shoulders. They arise due to abnormal bronchial budding during the embryological period. Only in 12 of these patients, including our case, the lesion was located in the periscapular area. Its treatment is surgical because of malignant transformation and infection. The recognition of this entity may help the surgeon for early diagnosis.

Subhepatic ciliated foregut cyst

Foregut cyst derives from the primitive foregut and occurs in the tracheobronchial tree, mediastinum, liver, pancreas, tongue, and upper digestive tract. We report the first case of a foregut cyst in the subhepatic area. A computed tomographic scan of a 45-year-old man with dull backache showed a discrete subhepatic multiloculated cystic lesion. The cyst lining consisted of ciliated, columnar epithelium, goblet cells, and underlying double layer of smooth muscle. In addition to positivity for cytokeratin and epithelial membrane antigen in the epithelial cells, focal weak positivity for thyroid transcription factor was present, a novel finding further supporting respiratory differentiation. We hypothesized the occurrence of this cyst in this location based on the embryonic communication between the thoracic and abdominal cavities through the pericardio-peritoneal canal, eventually separated by pleuroperitoneal membranes. Abnormal buds off the tracheobronchial tree may get pinched off by these membranes, leading to migration into the abdomen.