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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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Gong YY, Qian X, Liang B, Jiang MD, Liu J, Tao X, Luo J, Liu HJ, Feng YG. Retroperitoneal tumor finally diagnosed as a bronchogenic cyst: A case report and review of literature. World J Clin Cases 2022; 10:6679-6687. [PMID: 35979308 PMCID: PMC9294898 DOI: 10.12998/wjcc.v10.i19.6679] [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: 01/05/2022] [Revised: 02/10/2022] [Accepted: 05/08/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Retroperitoneal bronchogenic cyst (RBC) is an extremely rare developmental abnormality. Most are benign tumors but malignant transformation is possible. Because of their anatomical position, RBCs are easily misdiagnosed as adrenal or pancreatic solid tumors on radiological evaluation. Here, we report a case of RBC, review the literature, and summarize some important features.
CASE SUMMARY A 49-year-old woman was incidentally found to have a retroperitoneal tumor during a physical examination. Enhanced computed tomography and laboratory evaluations, including routine blood examination, blood biochemistry, 24-h urine 17 ketones, 17 hydroxyls, adrenocortical hormone, serum potassium concentration, serum amylase, lipase, and epithelial tumor markers, revealed a moderate density, 54 mm × 40 mm mass with a clear boundary near the left adrenal gland. The were no abnormalities in the blood and urine values. Because the patient had a history of hypertension and the location of the mass was adjacent to the adrenal gland, it was initially diagnosed as a left adrenal tumor and was resected by retroperitoneal laparoscopy. However, the pathological examination after surgery confirmed it to be a bronchogenic cyst.
CONCLUSION Retroperitoneal laparoscopic surgery can be prioritized for symptomatic RBC patients. Conservative treatment is feasible for selected patients.
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Affiliation(s)
- Yang-Yang Gong
- Faculty of Medicine, Zunyi Medical University, Zunyi 563000, Guizhou Province, China
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Xin Qian
- Faculty of Medicine, Zunyi Medical University, Zunyi 563000, Guizhou Province, China
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Bo Liang
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Ming-Dong Jiang
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Jun Liu
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Xing Tao
- Faculty of Medicine, Zunyi Medical University, Zunyi 563000, Guizhou Province, China
| | - Jing Luo
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - Hong-Jian Liu
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
| | - You-Gang Feng
- Faculty of Medicine, Zunyi Medical University, Zunyi 563000, Guizhou Province, China
- Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China
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