Case report: Intradiaphragmatic bronchogenic cyst

Intramural esophageal bronchogenic cyst mimicking achalasia in a toddler

Bronchogenic cysts are congenital malformations of the tracheobronchial tree. We describe a 20-month-old male who presented with persistent non-bilious emesis; manometry and imaging were consistent with esophageal achalasia. During a planned laparoscopic Heller myotomy, an intramural bronchogenic cyst was discovered in the anterior esophagus at the level of the gastroesophageal junction and successfully resected with resolution of his symptoms.

Intradiaphragmatic Bronchogenic Cysts: Case Report and Systematic Review

Bronchogenic cysts (BC) are congenital abnormalities that occur most commonly within the mediastinum, and rarely occur within the diaphragm. We present the 21st case of an intradiaphragmatic bronchogenic cyst in the English literature, and review all previous published cases. Analysis includes presenting clinical symptoms, relevant radiologic studies, surgical approaches to resection, and management of the diaphragm, among other relevant data. These lesions should remain on the differential diagnosis in cases of unusual masses in the region of the diaphragm.

Bronchogenic cyst of the right hemidiaphragm presenting with pleural effusion

Bronchogenic cysts are developmental foregut anomalies usually located within the mediastinum or lung parenchyma. An isolated bronchogenic cyst of the diaphragm is very rare. Our case was a 56-year-old female patient who presented with pleuritic chest pain in her right chest. Chest and abdominal computed tomography revealed a large lobulated cystic mass that was accompanied with pleural effusion in the right lower hemithorax. The tumor showed focally calcified areas in the wall and abutted against the diaphragm. We performed complete excision of the cyst including a portion of the diaphragm attached to it. The pathological diagnosis was established as the bronchogenic cyst originating from the diaphragm. We report this case with a review of the literature.

Tumors of the diaphragm

Primary tumors of the diaphragm are rare. The most common benign cystic lesions of the diaphragm are bronchogenic or mesothelial cysts, while the most common benign solid lesion is a lipoma. Benign tumors of the diaphragm are resected if they are symptomatic or if there is a doubt about the diagnosis. The most common primary malignant lesion is rhabdomyosarcoma. Malignant tumors are treated based on histology and often with chemotherapy and/or radiation along with surgical resection if feasible. Endometriosis, a benign process that metastasizes to the diaphragm, is typically treated medically; surgical ablation or resection is considered only after failed conservative treatment. Surgical resection of metastatic malignant tumors, such as ovarian cancer and thymoma, as well as malignancies affecting the diaphragm by direct extension, such as mesothelioma, lung, and esophageal cancer, may provide some survival advantage.

Intradiaphragmatic extralobar sequestration-a rare pulmonary anomaly

Extralobar pulmonary sequestrations are most commonly found within the thoracic cavity, but have been described within the abdomen. We present the case of a 16-month-old boy with an intradiaphragmatic pulmonary sequestration and demonstrate a computed tomographic scan finding that might help identify this extremely rare abnormality preoperatively.

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.

Intramural esophageal bronchogenic cysts: a review of the literature

Bronchogenic cysts are rare congenital cystic lesions mostly located in the middle and superior mediastinum. Esophageal bronchogenic cysts are extremely rare. We review here 23 cases reported in English in the literature to date of intramural esophageal bronchogenic cyst and their features, including our patient. Although they are extremely rare, intramural esophageal bronchogenic cysts should be kept in mind in the differential diagnosis of benign esophageal lesions. With accurate diagnosis and treatment the prognosis is excellent and serious complications may be prevented.

Bronchogenic cyst of the esophagus: clinical and imaging features of seven cases

Seven unusual cases of esophageal bronchogenic cyst (EBC) are presented. Different from mediastinal or pulmonary bronchogenic cysts, EBCs predominately affect young women (six out of seven cases; mean age, 29.9 years), and clinically, such cases were characterized by dysphagia and chest pain, especially during exercise. On radiographs and computed tomographs, EBCs typically appeared as 3- to 4-cm midthoracic cystic masses close abutting to the midthoracic esophagus. Rarely, exophytic lower thoracic EBC may mimic lung nodule. Total cyst excision usually offers satisfactory outcome with no recurrence in long-term follow-up.

[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.