Retroperitoneal Bronchogenic Cyst Managed With Retroperitoneoscopic Surgery

Abstract

Bronchogenic cysts develop most commonly in the mediastinum posterior to the carina. Retroperitoneal bronchogenic cysts are rare developmental anomalies arising from the accessory lung buds of the foregut. We report a retroperitoneal bronchogenic cyst that was managed with retroperitoneoscopic surgery. CASE REPORT A 41-year-old woman presented with left flank pain 1 year in duration. Abdominal computerized tomography and ultrasonography demonstrated a 5.5 5.2 9.2 cm. cystic mass in the left suprarenal region (fig. 1, A). Magnetic resonance imaging (MRI) showed a well circumscribed retroperitoneal mass with high signal intensity on T1 and T2-weighted images (fig. 1, B and C). The cyst was believed to be proteinaceous. Abdominal aortography and renal angiography did not reveal any vascularity in the suspected area. Based on preoperative evaluation, retroperitoneal bronchogenic cyst, teratoma, neurogenic tumor and adrenal cyst were considered possible diagnoses. The patient underwent retroperitoneoscopy with 4 trocars inserted into the retroperitoneal space. Surgical exploration demonstrated no direct connection with the gastrointestinal tract, but the tumor was adherent to the adjacent tissue and was resected en bloc with difficulty. Histopathological examination showed that the cyst was lined with tall columnar epithelium without atypia, and the cyst wall contained thin smooth muscle bundles, seromucous glands and mature hyaline cartilage (fig. 2). Final diagnosis was bronchogenic cyst. Postoperative course was uneventful, and the patient required no analgesics. She was discharged home on postoperative day 7. DISCUSSION