ABSTRACT

We are presenting a case of a 78-year-old patient with a bronchogenic cyst (BC) which was located between two mediastinum spaces and even though the anomaly, the patient was asymptomatic. The patient presented with persistent retrosternal pain and the thoracic x-ray wrongly interpreted the presence of «cardiomegaly». The computed tomography showed that the BC was pressing the heart forward, which could have been the cause of the original symptoms.
Bronchogenic cysts are rare and infrequent congenital aberrations. The respiratory system develops from a ventral diverticulum of the foregut during the seventh week of gestation. The pharynx and esophagus are originated from the caudal region of this structure. The BC will develop from cells that separate from the initial tracheobronchial tree conserving the characteristics of the bronchial respiratory epithelium. Most of the BC are located in the thorax, either in the mediastinum or in the pulmonary parenchyma, but there are also very rare reports of BC in atypical locations. A secondary purpose of this review is to discuss the pathology, embryology and clinical pictures of these rare occurrences. According to their size and location, they will require the expertise of physicians of different specialties. The exact incidence of the BC is not known, since there are asymptomatic cases that eventually are found through autopsies or in patients that were asymptomatic during variable periods of time or had been detected through an incidental thoracic radiography or other imageology studies. In the reviewed literature the oldest case reported was a male that presented symptoms at 72 years of age. In this article the patient is a 78-year-old male that presented symptoms at that age. We can conclude that this patient is the case reported in the literature that remained asymptomatic for the longest period of time. The patient had surgery and the BC was extracted; the patient is in stable condition and asymptomatic.

KEYWORDS

Bronchogenic cysts, embryology, diagnosis, atypical cases.

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