A Retroperitoneal Bronchogenic Cyst Mimicking a Pancreatic or Adrenal Mass

Abstract

Retroperitoneal location of bronchogenic cysts is extremely rare. Most commonly they are encountered in the posterior mediastinum. Bronchogenic cysts arise from developmental aberrations of the tracheobronchial tree in the early embryologic period. We report a 42-year-old female patient with a retroperitoneal bronchogenic cyst in the left adrenal region. She was admitted to our hospital with epigastric pain and subsequently underwent CT of the abdomen. The examination revealed a mass related to the left adrenal gland. Endocrine tests for adrenal hypersecretion were negative. Because of the uncertain entity, laparoscopic adrenalectomy was performed. Pathological examination revealed a bronchogenic cyst in proximity to an inconspicuous left adrenal gland. Although very rare, bronchogenic cysts should be considered in the differential diagnosis of retroperitoneal cystic lesions and surgical resection pursued for symptom resolution and to establish a definitive histology.

Retroperitoneal Bronchogenic Cyst Originating from Diaphragmatic Crura

“…Retroperitoneal bronchogenic cysts can be of varying diameters up to 18 cm and can rarely be seen within the diaphragm [1,2,6,7]. They are usually pure simple cysts but may become complicated with mucus, protein, calcium, or blood products [3].…”

“…They are usually pure simple cysts but may become complicated with mucus, protein, calcium, or blood products [3]. Complicated cysts have high attenuation on CT and show high signal intensity on unenhanced T1-weighted MRI sequences [4,6]. A retroperitoneal bronchogenic cyst can mimic an adrenal or a pancreatic lesion and a teratoma or a urothelial cyst radiologically [1,2,5,6].…”

“…Complicated cysts have high attenuation on CT and show high signal intensity on unenhanced T1-weighted MRI sequences [4,6]. A retroperitoneal bronchogenic cyst can mimic an adrenal or a pancreatic lesion and a teratoma or a urothelial cyst radiologically [1,2,5,6]. MRI is superior to CT in the diagnosis and can easily exclude fat-containing lesions like teratomas or dermoid cysts on fat suppression images [4].…”

“…MRI is superior to CT in the diagnosis and can easily exclude fat-containing lesions like teratomas or dermoid cysts on fat suppression images [4]. Most cases are asymptomatic but can also present with pain or be secondarily infected or compress adjacent organs causing symptoms [1,2,[4][5][6][7]. Surgical excision is the treatment to avoid secondary infection, and no recurrence is expected [6].…”

“…Most cases are asymptomatic but can also present with pain or be secondarily infected or compress adjacent organs causing symptoms [1,2,[4][5][6][7]. Surgical excision is the treatment to avoid secondary infection, and no recurrence is expected [6]. Characteristic pseudostratified columnar epithelium, smooth muscle, mucoid material, and cartilage can be identified in histological specimens [1].…”