EC Clinical and Medical Case Reports

Congenital mediastinal cysts are characteristically benign lesion. Among the entities that make up the group, bronchogenic (CB), pericardial, enteric, and thymic cysts, lymphangioma, and esophageal duplication cyst. CB's represent about 50 - 60% of all mediastinal cysts. Characteristically exhibit clinical and radiological polymorphism, besides clinical manifestations that vary from asymptomatic pictures to respiratory failure. The presentation of CB in adults is rare, mostly found incidentally, with an asymptomatic course in most cases. Pulmonary CBs tend to be more symptomatic than those located in mediastinum, and it is estimated that 86.4% of symptomatic patients have complicated cyst. Treatment options depend on the patient's age and symptoms at presentation. For young patients, surgical resection is the only treatment of choice, whereas in asymptomatic adults there are controversies due to the risk of complications or degeneration. A conservative approach is suggested in high-risk patients. We report a case of a female, 30-year-old patient M.A.R.S presented with a mass located in the posterior mediastinum, without previous information. Previous history of COVID-19 infection requiring tracheostomy. Chest tomography with contrast was requested and showed presence of solid mass of oval aspect, without contrast enhancement, with possible origin in the middle mediastinum, compressing the right source bronchus, vein, pulmonary artery, measuring 6.7 x 5.3 x 9.4 cm. The patient maintained the same clinical pattern, asymptomatic and a surgical approach was chosen. As scheduled, an open thoracotomy was performed to remove a cyst in the posterior mediastinum. She returned to the outpatient clinic for postoperative follow-up with a histopathological report compatible with bronchogenic cyst.

Keywords: Mediastinal Diseases; Rare Diseases; Thoracic Surgery; Public Health; Evidence-Based Practice

1. Vilela TT., et al. “Congenital mediastinal cysts: imaging findings”. Radiologia Brasileira1 (2009): 57-62.
2. Limaiem Faten and Mouna Mlika. “Bronchogenic Cyst”. StatPearls, StatPearls (2023).
3. Pazello JA., et al. “Bronchogenic cyst in an unusual location”. Jornal Brasileiro de Patologia e Medicina Laboratorial2 (2019): 202-209.
4. Sarper A., et al. “Bronchogenic cyst”. Texas Heart Institute Journal2 (2003): 105-108.
5. Hiremath CS., et al. “Management of infected recurrent mediastinal bronchogenic cyst with tuberculous mediastinal lymphadenitis”. Indian Journal of Thoracic and Cardiovascular Surgery1 (2020): 67-70.
6. Votto M., et al. “An asymptomatic mediastinal cyst in a young child: Case report and summary of the literature”. Clinical Case Reports11 (202): 2163-2165.
7. Marcuse F., et al. “Symptomatic mediastinal mass in a 32-year-old male”. Breathe2 (2021): 210029.
8. Caterino U., et al. “Anterior bronchogenic mediastinal cyst as priority procedure for robotic thoracic surgery”. Journal of Thoracic Disease8 (2017): E674-E676.