Congenital bronchogenic cyst: A case study on early detection and surgical intervention

Abstract

Introduction

The patient showed an uneventful recovery post-surgery, underscoring the significance of early intervention in managing rare congenital anomalies. Bronchogenic cysts constitute 13–15 % of congenital cystic lung diseases and 6 % of childhood mediastinal masses. Arising from abnormal foregut development during embryogenesis, these cysts can be asymptomatic or cause serious complications, such as airway or vascular compression.

Case presentation

A 10-day-old female newborn presented with a pulmonary cystic lesion in the left upper lung lobe, identified via routine antenatal ultrasound. She was asymptomatic at birth, with no respiratory distress or congenital anomalies. Chest CT revealed a large bilocular cyst causing lung compression and mediastinal shift. Initial diagnosis suggested Congenital Pulmonary Airway Malformation (CPAM) Type 1. Video-assisted thoracoscopic surgery (VATS) successfully removed the lesion, with histopathology confirming a bronchogenic cyst.

Discussion

Bronchogenic cysts result from abnormal budding of the foregut during embryogenesis and typically present as unilocular cysts without communication with the bronchial tree. While often asymptomatic, these cysts can cause life-threatening complications due to compression effects. Imaging modalities, including prenatal ultrasonography, fetal MRI, and postnatal CT scans, are crucial for diagnosis. Histopathology provides confirmation by identifying the characteristic ciliated pseudostratified columnar epithelium. Differential diagnoses, such as CPAM or lung sequestration, must be ruled out. Surgical excision is the gold standard treatment to prevent complications like infection, hemorrhage, or malignant transformation.

Conclusion

This case underscores the importance of early diagnosis and prompt surgical management of bronchogenic cysts. Timely intervention ensures a successful recovery and prevents life-threatening complications, even in asymptomatic infants.