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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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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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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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Liang MK, Yee HT, Song JW, Marks JL. Subdiaphragmatic Bronchogenic Cysts: A Comprehensive Review of the Literature. Am Surg 2020. [DOI: 10.1177/000313480507101210] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Bronchogenic cysts are foregut-derived developmental anomalies most commonly encountered in the mediastinum and rarely in the abdomen or retroperitoneally. A comprehensive review of the English-language literature of subdiaphragmatic bronchogenic cysts (sBCs) revealed only 48 reported cases of sBC. Although most cases are incidentally discovered, preoperative differential diagnosis often includes tumors with malignant potential and necessitates surgical resection to obtain a definitive diagnosis. Herein, we describe a case of a 46-year-old female presenting with intermittent left flank pain, upon which computed tomography demonstrated a retroperitoneal mass. Upon resection, histopathology revealed the mass to be a thin-walled cystic mass lined by ciliated columnar cells and cartilage, consistent with a subdiaphragmatic bronchogenic cyst. A comprehensive literature review of sBC was also performed.
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Affiliation(s)
- Mike K. Liang
- Departments of Surgery, Bellevue Hospital, New York, New York
| | - Herman T. Yee
- Departments of Pathology, Bellevue Hospital, New York, New York
| | - Jae W. Song
- New York University School of Medicine, New York, New York
| | - Jenifer L. Marks
- Department of Surgery, New York Weill Cornell Medical Center, New York, New York
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Ultrasound follow-up of an unusual giant urinoma in a newborn. J Ultrasound 2018; 21:65-68. [PMID: 29374393 DOI: 10.1007/s40477-016-0224-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 11/16/2016] [Indexed: 10/20/2022] Open
Abstract
Urinoma, defined as an encapsulation of urine caused by urine extravasation into the perirenal space either through rupture of a calyceal fornix or a tear in the renal parenchyma, is an uncommon finding in prenatal diagnosis and the neonatal period. Urinoma can be associated with any urinary tract obstruction, or, as reported in several published cases, related to vesicoureteral reflux, kidney dysplasia, or complication arising during amniocentesis. We report on a newborn with a perinatal urinoma, with initial slight corpusculated fluid associated with nonobstructive and nonrefluxing megaureter, and no signs of kidney dysplasia. Close sonography follow-up of the urinoma allowed complex differential diagnoses, including cystic, septated, and solid perirenal masses, due to dissimilar and peculiar ultrasound images during urinoma evolution stages.
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Runge T, Blank A, Schäfer SC, Candinas D, Gloor B, Angst E. A retroperitoneal bronchogenic cyst mimicking a pancreatic or adrenal mass. Case Rep Gastroenterol 2013; 7:428-32. [PMID: 24403880 PMCID: PMC3884166 DOI: 10.1159/000355879] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Retroperitoneal location of bronchogenic cysts is extremely rare. Most commonly they are encountered in the posterior mediastinum. Bronchogenic cysts arise from developmental aberrations of the tracheobronchial tree in the early embryologic period. We report a 42-year-old female patient with a retroperitoneal bronchogenic cyst in the left adrenal region. She was admitted to our hospital with epigastric pain and subsequently underwent CT of the abdomen. The examination revealed a mass related to the left adrenal gland. Endocrine tests for adrenal hypersecretion were negative. Because of the uncertain entity, laparoscopic adrenalectomy was performed. Pathological examination revealed a bronchogenic cyst in proximity to an inconspicuous left adrenal gland. Although very rare, bronchogenic cysts should be considered in the differential diagnosis of retroperitoneal cystic lesions and surgical resection pursued for symptom resolution and to establish a definitive histology.
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Affiliation(s)
- Tina Runge
- Department of Visceral Surgery and Medicine, Inselspital, University of Bern, Bern, Switzerland
| | - Annika Blank
- University of Bern and Institute of Pathology, University of Bern, Bern, Switzerland
| | - Stephan C Schäfer
- University of Bern and Institute of Pathology, University of Bern, Bern, Switzerland
| | - Daniel Candinas
- Department of Visceral Surgery and Medicine, Inselspital, University of Bern, Bern, Switzerland
| | - Beat Gloor
- Department of Visceral Surgery and Medicine, Inselspital, University of Bern, Bern, Switzerland
| | - Eliane Angst
- Department of Visceral Surgery and Medicine, Inselspital, University of Bern, Bern, Switzerland
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A lesser sac bronchogenic cyst treated with laparoscopic reduced port surgery. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2013. [DOI: 10.1016/j.epsc.2013.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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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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An unusual left upper quadrant mass: a bronchopulmonary foregut malformation. Case Rep Surg 2013; 2013:740292. [PMID: 23533917 PMCID: PMC3600227 DOI: 10.1155/2013/740292] [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: 11/23/2012] [Accepted: 01/29/2013] [Indexed: 12/05/2022] Open
Abstract
We report a case of a lady who presented with epigastric discomfort. Physical examination revealed a large left upper quadrant mass filling the left upper quadrant. Following extensive preoperative evaluation, she underwent resection of this 9 × 10 × 11 centimeter mass with en bloc excision of a portion of the left hemidiaphragm. She made an uneventful postoperative recovery. Histopathology revealed a bronchopulmonary foregut malformation with pulmonary sequestration. This developmental anomaly of the foregut typically occurs in the thoracic cavity; however, it can occur below the diaphragm. Herein we report a case and a detailed review of the embryology, clinical features, and management of these extremely rare clinical entities.
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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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