Symptomatic Bronchogenic Cyst in a Lipomatous Interatrial Septum

Abstract

Intracardiac bronchogenic cysts are extremely rare congenital anomalies that arise during foregut development when the embryologic heart tube and ventral foregut are in close proximity to one another. We report a case of an interatrial septal bronchogenic cyst found on non-contrast enhanced computed tomography (CT) in a 66-year-old female who presented to the emergency department with chest pain. Further cardiac investigations, including contrast-enhanced CT angiogram of the heart, transthoracic echocardiogram, and transesophageal echocardiogram, revealed a cystic mass in the lipomatous interatrial septum. The patient was subsequently diagnosed with a bronchogenic cyst of the interatrial septum. No surgical intervention was pursued, as the mass remained stable, and the cardiothoracic surgeon did not recommend excision. This case highlights a rare case of a symptomatic bronchogenic cyst arising in the interatrial septum diagnosed by imaging modalities. Bronchogenic cysts should be included in the differential diagnosis of intracardiac tumors.

Multimodality imaging of a rare intracardiac bronchogenic cyst

“…We believe that our patient's first-degree AV block may have resulted from the interatrial IBC. Excision of IBCs is debatable and usually reserved for rapidly growing and/or symptomatic lesions [14] , [15] , [16] . A decision was made to proceed with surgical treatment following failure of pain relief in our patient.…”