6 Year Old Boy with a Right Posterior Thoracic Mass

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Bronchogenic cysts result from the abnormal or late budding of the ventral lung bud or the tracheobronchial tree during the process of the development. Primary Bronchogenic cysts of cardiac origin or extension are rare. Bronchogenic cysts can be detected in fetus or in stillbirths and it is well recognized in babies or infants. Bronchogenic cysts are rare lesions which originate from primitive tracheobronchial tree. They are primarily located in the thorax. Extrathoracic locations may be either in the immediate vicinity of the thoracic cage or more remote periscapular location which is extremely rare. The clinical presentations are usually releated to trancheal and tracheobronchial compressions. Typical localization of bronchial cysts has been reported for esophageal, pericardial, dermal cervical, diaphragmatic or intradural spaces, but such localizations are very rare.

A 6-years old male with presented with chest typical chest pain, discomfort, paroxysmalpalpitations continuing, for one month, cough, fever was admitted in our department with bronchogenin cyst extending to the right atrial wall. Physical examination, chest radiography, and blood analysis were found to be normal. The computed tomography (CT) confirmed giant cystic mass with a diameter of 6,5 x 5,5 x 5,5cm. Following standard a right posterolateral thoracotomy, we performed tumor enucleation and managed to resect the cyst from the atrial wall with the use of a side-biting clamp on the right atrial wall, which was repaired with continuous 4-0 polypropylene sutures (Ethicon, Somerville, NJ, USA). The patient was taken to the intensive care unit and weaned off mechanical ventilation in 6 hours. He was taken to the ward next day and discharged from the hospital on the postoperative 5th day. Microbiologic examination ended sterile and Bronchogenic cyst diagnosis was confirmed with detailed histopathologic examination. Grossly, the excised tumor measured 6,5 x 5,5 x 5,5cm and had multi-cystic features with turbid contents. Microscopically the tumor consisted of thin-walled multiple cysts attached to the respected myocardium. The inner cavities were lined with pseudo-stratified ciliated columnar epithelium and cartilages, which are characteristic features similar to those of normal bronchi and confirm a pathologic diagnosis of Bronchogenic cyst.