Supradiaphragmatic bronchogenic cyst extending into the retroperitoneum

We experienced a case of bronchogenic cyst located on the left lower pleural space extending into the retroperitoneum in a 33-year-old man with left chest pain. Preoperative imaging studies and operative findings showed a broad-based cystic mass on the left lower posterior pleura and diaphragmatic pleura extending into the retroperitoneal region across the diaphragm. Histologic studies proved this mass to be a bronchogenic cyst.     

Intrapericardial bronchogenic cyst--a report of two surgical cases

Two cases of intrapericardial bronchogenic cyst are reported. Case 1 was a 58-year-old man with a complaint of exertional dyspnea. A chest X-ray film showed a right hilar mass shadow. Echocardiographically the mass showed cystic pattern in the pericardium. A pulmonary angiogram revealed a mass displacing the right pulmonary artery superiolaterally and left atrium and pulmonary vein inferiorly. The preoperative diagnosis was intrapericardial cyst. Subtotal resection of intrapericardial cyst was performed via right thoracotomy. Histological diagnosis was bronchogenic cyst. The postoperative course was uneventful. Case 2 was a 41-year-old man. A displacement of the esophagus and duodenal ulcer was pointed out in the upper gastrointestinal series. A chest X-ray film showed a right hilar mass shadow. Since echocardiogram and pulmonary angiogram revealed similar findings to those in case 1, intrapericardial bronchogenic cyst was suspected preoperatively. Complete resection of the intrapericardial cyst was made via right thoracotomy. Histological diagnosis was bronchogenic cyst. The postoperative course was uneventful.     

Subdiaphragmatic bronchogenic cyst in the left crus of diaphragm: report of a case

A 39-year-old man who had a subdiaphragmatic bronchogenic cyst in the left crus of diaphragm received surgical treatment. The cyst was located in the retroperitoneum just below the diaphragm and was adhered to the left crus of diaphragm and unconnected with any other structures. The surgically resected cyst was 50 x 25 x 22 mm diameter and the wall was thin and contained white turbid mucus. Histologically, the cyst consisted of ciliated epithelium, mucus glands, smooth muscle, cartilage and this evidence established the final diagnosis of bronchogenic cyst. The post operative course was uneventful and the patient was discharged 10 days after operation. This is the 4th reported case of a subdiaphragmatic bronchogenic cyst in the Japanese literature.     

Diaphragmatic bronchogenic cyst: a rare case report

Retroperitoneal bronchogenic cysts are rare and those located in the diaphragm are exceptional. We describe an additional case of bronchogenic cyst of the left crus of diaphragm. Diagnosis of a diaphragmatic lesion was confirmed during laparotomy and complete resection was successful. Final diagnosis was done on pathology.     

Laparoscopic resection of an intradiaphragmatic bronchogenic cyst

BACKGROUND: A 43-year-old woman with recurrent hiccup and discomfort in the right upper abdomen was diagnosed by computed tomographic (CT) scan with a cystic tumor in the right liver. Echinococcus serology was negative. METHODS: A laparoscopic procedure was chosen as standard therapy for symptomatic cystic liver tumors. The presumed tumor turned out to be a diaphragmatic cyst 8 cm in diameter at the center of the right hemi-diaphragm. By using the ultrasonic device, the cystic tumor was completely and safely removed from the diaphragm. The defect was closed by using nonabsorbable sutures. A chest drain was inserted for 1 day. RESULTS: The postoperative course was uneventful, and the patient was discharged on day 4. The histopathological examination revealed a bronchogenic cyst. No recurrence was noted by CT-scan after 12 and 24 months. CONCLUSIONS: Due to this rare diagnosis, the intradiaphragmatic location of a bronchogenic cyst is difficult to identify with radiological methods. Complete surgical excision is the treatment of choice. The conventional surgical approach is a posterolateral thoracotomy. In the literature, video-assisted thoracoscopic surgery (VATS) has been described as a safe and effective procedure. In our case, we could demonstrate that the laparoscopic excision of a cyst including partial diaphragmatic resection can be done safely in a diaphragmatic location with all the advantages of minimally invasive surgery.     

Subcarinal bronchogenic cyst with high carbohydrate antigen 19-9 production

In a rare case of bronchogenic cyst with high carbohydrate antigen (CA) 19-9 production, a 57-year-old man with coughing and chest pain was diagnosed with a subcarinal mediastinal tumor. Fiberoptic bronchoscopy showed an erosive mucosal lesion overlying the area of extrinsic compression at the membranous of the right mainstem bronchus. Serum carbohydrate antigen 19-9 was elevated at 1300 U/ml. Thoracotomy showed an encapsulated cyst tightly adhering to the right main bronchus. The cyst was extirpated after ablation at the adherent cystic wall by electrocautery. Although intracystic carbohydrate antigen 19-9 concentration was very high, serum carbohydrate antigen 19-9 and bronchoscopic findings returned to normal postoperatively. The histological diagnosis was consistent with a bronchogenic cyst and carbohydrate antigen 19-9 could be immunohistochemically demonstrated within its epithelium.     

Progressive intraparenchymal bronchogenic cyst in a neonate.

Neonatal parenchymal bronchogenic cysts (BC) are a very rare congenital anomaly. Usually patients with BC are born with severe respiratory distress or cardiovascular insufficiency are asymptomatic till they grow up to older children and adults. We report a case of neonatal BC with a prenatal diagnosis of congenital tracheobronchial cystic anomalies of the right lung. The cyst was 36 mm in diameter at 17 week gestational period but diminished in size to 21 mm at 35 weeks. After birth, chest X-ray demonstrated a growing cyst 50 mm in diameter and gradual displacement of the heart and mediastinum from the right to the left day by day. Right S3 segmentectomy was performed on the 5th day.     

A case report of a mediastinal bronchogenic cyst with back pain

We performed thoracoscopic surgery for a mediastinal bronchogenic cyst with complaining of back pain. The patient, a 38-year-old male, was admitted with an abnormal shadow on chest X-ray. Chest CT showed a localized tumor on the mediastine. MRI showed a cyst. Under thoracoscopy the tumor was based on parietal pleura and movable in chest cavity. We concluded that back pain was caused by a stimulus of a nerve in parietal pleura. Pathological diagnosis was a bronchogenic cyst.     

Thoracoscopic removal of bronchogenic cyst of the posterior mediastinum; report of a case

A 15-year-old female was admitted to our hospital with an abnormal chest X-ray shadow in the left posterior mediastinum found at health screening. Magnetic resonance imaging (MRI) suggested that the cystic lesion contained a viscous liquid. The lesion was removed using a thoracoscope and diagnosed as bronchogenic cyst. Postoperative pathological evaluation was consistent with the initial diagnosis of bronchogenic cyst. This case illustrates the usefulness of thoracoscopic surgery for diagnosis and extirpation of bronchogenic cyst.     

Mediastinal bronchogenic cyst associated with high serum level of CA19-9 —A surgical case report—

We reported a case of mediastinal bronchogenic cyst in a patient with a high serum level of CA19-9. The patient, a 41-year-old man, presented with a complaint of persistent fever. Chest X-ray examination, computed tomograp-hy and magnetic resonance imaging showed a subcarinal mass shadow which was diagnosed preoperatively as a bronchogenic cyst. The serum level of CA19-9 was 73 U/ml. The cyst was partially removed via right thoracotomy. Histopathological findings were compatible with bronchogenic cyst. The CA19-9 level in the specimen was 134000 U/ml. The serum level of CA19-9 decreased to normal postoperatively. The postoperative course was uneventful.     

Intra-esophageal rupture of a bronchogenic cyst

Bronchogenic cysts usually are an asymptomatic disease and present as an incidental finding in the chest X-rays. They require a complete and early surgical excision to prevent complications and recurrences. We report a rare case of a voluminous symptomatic para-esophageal bronchogenic cyst complicated by an esophageal fistula. The initial video-assisted thoracoscopic surgery excision of the cyst was converted in open thoracotomy to suture the esophagus and interpose omentum. Previously, only four cases of para-esophageal bronchogenic cysts with esophageal communication have been reported.     

Video-assisted thoracoscopic excision of intradiaphragmatic bronchogenic cysts: two cases

We report two cases of bronchogenic cyst in the diaphragm. Case 1 was a female patient with hepatocellular carcinoma. Computed tomography showed a tumor in the right lower lung and metastasis was suspected initially because of underlying disease and imaging findings. Case 2 was a female patient who presented with prolonged intermittent cough. Computed tomography showed a tumor in the left lower lung. Both tumors were excised by video-assisted thoracoscopic surgery, and the diagnosis was confirmed by histopathology.     

Mediastinal bronchogenic cyst presenting with pericardial effusion

We report a case of a 58-year-old woman who had a bronchogenic cyst presenting with pericardial effusion. Initially, the effusion had disappeared prior to resection of the cyst, but it reappeared with additional symptoms. Resection of the bronchogenic cyst resulted in complete resolution of the pericardial effusion and additional symptoms such as progressive dyspnea and chest pain. Application of surgical treatment for asymptomatic cysts in adults remains controversial, but we recommend that mediastinal cysts which present with any symptoms should be resected at the time of their discovery, even though the symptoms disappeared for a while.     

Large bronchial cyst causing compression of the left atrium.

We describe here a case with a large bronchogenic cyst treated by surgical resection, who presented with evidence of left atrial overload on electrocardiogram (ECG). The 50-year-old male patient presented with the chief complaint of heaviness in the chest on exertion. An ECG revealed evidence of left atrial overload, and echocardiography and imaging revealed a mass having a maximum diameter of 9 cm on the cranial aspect of the left atrium, caudal to the tracheal bifurcation. The patient was treated by surgical resection of the cystic mass via right anterolateral thoracotomy. His postoperative course was satisfactory and the patient was relieved of his main symptom.     

Zystische Raumforderung im hinteren Mediastinum

We present the case of a 52-year-old male who underwent thoracotomy for resection of a suspected bronchogenic cyst in the right posterior mediastinum. The size of the tumor had increased over years, according to repeated X-rays, and the cyst became symptomatic with obstruction of the right subclavian and jugular veins. To our surprise, histopathology revealed a hydatid cyst.     

A case of double bronchogenic cysts in the mediastinum

A 42-year-old house wife had suffered from abnormal mass lesion in the right pulmonary hilum on her chest X-ray film. MRI showed another mediastinal mass between IVC and descending aorta with high T1 and T2 intensity. Thoracic CT done before MRI missed the latter lesion because only upper mediastinal scanning had been performed. At operation subcarinal and right paraesophageal cysts were successfully removed. Histological examination of the subcarinal cyst showed ciliated pseudostratified columnar epithelium lining, and its thin wall consisted of partly smooth muscle bundle, lymph node, calcification, inflammatory cell infiltration and hemorrhage. The paraesophageal cyst lined by a ciliated pseudostratified columnar epithelium, and the wall consisted of mostly fibrous connective tissue with partly smooth muscle bundle. Although the both cysts were diagnosed as bronchogenic origin, definitive bronchial glands and cartilage could not be recognized. The postoperative course was uneventful. This is the first case report of mediastinal double bronchogenic cysts appeared in the Japanese literature.     

Unusual presentation of a large tension bronchogenic cyst in an adult.

A routine chest radiograph in a 20 year old man revealed a giant air filled cavity of the left hemithorax under tension. At thoracotomy a large left lower lobe intraparenchymal cyst required lobectomy and the pathological findings were consistent with a bronchogenic cyst. Although tension bronchogenic cysts are common in infants, this case demonstrates their unusual presentation in an adult.     

A case of paraesophageal bronchogenic cyst with esophageal communication]

A case of mediastinal bronchogenic cyst communicating with the esophagus was reported. Previously, only 2 cases have been reported in the available literature. A 34-year-old man was admitted with a cystic mass communicating with the esophagus which was demonstrated on a barium study. Operation was performed with a suspect of esophageal diverticulum or congenital cyst with esophageal communication. At right thoracotomy, a mass measuring 6.0 x 5.0 cm with a well-defined patent communication to the esophagus was resected. It was a monolocular cyst containing a small amount of viscous mucus. Histologically, the cyst lined by a ciliated columnar epithelium, and it was diagnosed as a bronchogenic cyst because of the presence of the mucous glands, smooth muscle tissue and cartilage. This is the first case report of mediastinal bronchogenic cyst with esophageal communication appeared in the Japanese literature.     

Mediastinal bronchogenic cyst manifesting as a catastrophic myocardial infarction

Congenital bronchogenic cysts of the lung and mediastinum develop from the ventral foregut during embryogenesis. These cysts are often incidental radiologic findings in adults, but patients can be seen with symptoms of chest pain, cough, dyspnea, or any combination of these. Acute presentations are unusual and have rarely been reported. We present the unique case of a 36-year-old man seen with an acute coronary syndrome and sudden hemodynamic collapse. The patient sustained a massive and ultimately fatal myocardial infarction, compression of the left main coronary artery by a bronchogenic cyst was demonstrated at postmortem examination. If detected, bronchogenic cysts should be surgically excised to limit associated morbidity and mortality.     

Unusual presentation of a cutaneous bronchogenic cyst in an asymptomatic neonate

Cutaneous presentations of bronchogenic cysts are rare in all age groups. Previous reports of cutaneous manifestations of bronchogenic cysts have been described as nodular, adherent masses, most frequently with a suprasternal location. We report a unique presentation of an infant with a pedunculated, anterior chest wall mass, which was identified as a bronchogenic cyst.