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Bronchogenic Cysts Go Beyond Congenital Anomalies: A Series of 9 Adult Cases FREE TO VIEW

Chad Hall, MD; Karin Trujillo, MD; Rudy Lackner, MD
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University of Nebraska Medical Center, Omaha, NE

Chest. 2014;146(4_MeetingAbstracts):351A. doi:10.1378/chest.1983740
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SESSION TITLE: Surgery Student/Resident Case Report Posters

SESSION TYPE: Medical Student/Resident Case Report

PRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PM

INTRODUCTION: Bronchogenic cysts are considered congenital bronchopulmonary anomalies that result from abnormal budding of the foregut during embryogenesis. They usually present in the 2nd decade of life causing dyspnea, wheezing, chronic cough, and pneumonia. Bronchogenic cysts that present in adulthood are still considered congenital anomalies, because no case reports have documented the formation of a bronchogenic cyst in adults. This study documents the interval development of a bronchogenic cyst in an adult and summarizes the management of these anomalies at a single institution over 13 years.

CASE PRESENTATION: Nine patients between the ages of 24-64 underwent surgical management of intrathoracic bronchogenic cysts. The population consisted of 5 males and 4 females. Medical records were evaluated for presenting symptoms, pre-operative evaluation, and surgical management.

DISCUSSION: All patients in this study underwent resection. The majority of patients were symptomatic at the time of operation. Symptoms included pain, shortness of breath, hemoptysis and atrial fibrillation. Mean age was 43.2±16.4 years. Procedures included VATS resection in 7 patients. Mean length of stay was 4.8±3.1 days. Chest tubes were removed on hospital day 2.8±1.0. Complications were noted in 2 of 9 (22%) patients, which included cellulitis and an intra-operative pulmonary vein injury. One patient presented with chest pain 1 year after undergoing a right VATS granuloma resection. Imaging of his chest revealed the interval development of a bronchogenic cyst.

CONCLUSIONS: Not all bronchogenic cysts should be considered congenital anomalies. This study demonstrates bronchogenic cysts may develop in adulthood and present throughout many decades of life. They can successfully be resected with few operative complications. Location of cysts within the thorax is variable and each case may require a different surgical approach.

Reference #1: Zylak, C. J., Eyler, W. R., Spizarny, D. L., et al. (2002). Developmental lung anomalies in the adult: Radiologic-pathologic correlation. Radiographics : A Review Publication of the Radiological Society of North America, Inc, 22 Spec No, S25-43.

Reference #2: Patel, S. R., Meeker, D. P., Biscotti, C. V., et al. (1994). Presentation and management of bronchogenic cysts in the adult. Chest, 106(1), 79-85.

Reference #3: Suen, H. C., Mathisen, D. J., Grillo, H. C., et al. (1993). Surgical management and radiological characteristics of bronchogenic cysts. The Annals of Thoracic Surgery, 55(2), 476-481.

DISCLOSURE: The following authors have nothing to disclose: Chad Hall, Karin Trujillo, Rudy Lackner

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