Background:
Bronchogenic cysts are rare congenital malformations of the foregut that typically present in the mediastinum or lung parenchyma. Antenatal detection is increasing due to routine fetal ultrasound and MRI. However, some cases may pose complex diagnostic and surgical challenges, especially when the lesion is large and its topography is uncertain.
Case Presentation:
We report the case of an 18-month-old male infant who was diagnosed antenatally with a left-sided thoracic cystic mass. Postnatal imaging follow-up showed progressive increase in the volume of the lesion, reaching a diameter of 8 cm , with significant mass effect. Preoperative assessment, including chest CT was inconclusive regarding the exact topography suggesting either a superior mediastinal origin or a left upper lobar pulmonary origin. The patient underwent surgical excision via thoracotomy.
Results:
Complete resection of the cyst was achieved without intraoperative complications. Intraoperative findings confirmed a well-encapsulated cyst, not communicating with the bronchial tree. Histopathological examination confirmed the diagnosis of a bronchogenic cyst
Conclusion:
This case highlights the diagnostic difficulties associated with giant congenital thoracic cysts, particularly in distinguishing mediastinal from intrapulmonary lesions when large. Antenatal detection, careful imaging follow-up, and multidisciplinary planning are key. Surgical excision remains the definitive treatment, both diagnostic and therapeutic.
Keywords: Bronchogenic cyst, infant, congenital lung malformation, thoracic mass, antenatal diagnosis, thoracic surgery
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