Subcutaneous bronchogenic cyst

Abstract

Bronchogenic cysts occur due to the anomalous development of the primitive tracheobronchial tree early in fetal life. They are usually present in middle mediastinum. Rarely, they have been found in other locations. We describe two patients with subcutaneous bronchogenic cysts located over manubrium sterni with special emphasis on the difficulties in pre-operative diagnosis. The two boys were managed by complete excision of the cysts. The children are well on follow-up.

Cutaneous Bronchogenic Cyst: An Unusual Cause Of Lump: A Diagnostic Challenge

“…Smooth muscle fibers are associated in 70%, mucus gland in 53% and cartilage in upto 7% cases. [1,4,5] Our case also had similar clinical presentation and microscopy to warrant the diagnosis of bronchogenic cyst. A differential diagnosis for bronchogenic cyst includes branchial cleft cyst, thyroglossal duct cyst, mature cystic teratoma, cutaneous ciliated cyst, dermoid cyst, epidermal inclusion cyst, infundibular cyst and trichilemmal cyst.…”

“…[4] This is possibly due to its rarity and at times unusual presentation. The diagnosis of cutaneous bronchogenic cyst is usually a histological surprise and preoperative diagnosis of this entity is seldom made.…”

“…During the beginning of the 5 th week of gestation, laryngo-tracheal groove separates the primitive foregut into dorsal and ventral structures. [2,4,5] The dorsal anlage forms the oesophagus, whilethe ventral anlage develops into tracheobronchial tree.Bronchogenic cysts form due to abnormal development occuring in the distal tracheobronchial tree. [8] However, the origin of the cutaneous bronchogenic cysts can also be explained by another hypothesis which states that a part of the anterior portion of the developing lung gets pinched off during the process of fusion of the right and left bars of sternum precursors, leading topresternal localization of the bronchogenic cysts.…”

“…[8] However, the origin of the cutaneous bronchogenic cysts can also be explained by another hypothesis which states that a part of the anterior portion of the developing lung gets pinched off during the process of fusion of the right and left bars of sternum precursors, leading topresternal localization of the bronchogenic cysts. [4] As far as extrathoracic locations at unusual sites like neck, chin,shoulder are concerned, pathogenesis can be explained by the migration of these sequestered structures in the developing embryo or in situ development of metaplastic respiratory epithelium from pre-existing cutaneous tissue and primary anomalous differentiation in the developing skin. [2] These lesions usually present as an asymptomatic midline subcutaneous cystic and nontender nodule.…”

“…[3] Unusual sites of presentation include skin, subcutaneous tissue,pericardium and retroperitoneum. [2,4] Under cutaneous location, most common site is the suprasternal notch, followed by presternal area, neck and scapula. [5] Case report An 11 year old male child presented to the outpatient department with a swelling over manubrium sterni since birth.…”