Yang Bin, Liu Lei, Tian Xiaojun, Hou Xiaofei, Lu Min, Ma Lulin
Department of Urology, Peking University Third Hospital.
Department of Pathology, Peking University Health Science Center, Beijing, China.
Ann Med Surg (Lond). 2023 Mar 9;85(3):473-476. doi: 10.1097/MS9.0000000000000182. eCollection 2023 Mar.
Bronchogenic cyst is a rare congenital malformation of the tracheobronchial bud originating from the primitive foregut, especially in the retroperitoneal region. Retroperitoneal bronchogenic cysts in adults are difficult to make an accurate diagnosis preoperatively.
We present three cases of retroperitoneal bronchogenic cysts resembling adrenal tumors in adults. Three cases were asymptomatic, and all were located on the left side. There was no significant enhancement of the cyst walls on contrast-enhanced computed tomography. Two cases presented with typical multilocular sacs and scattered calcification on radiology, whereas the other one showed unilocular sacs, without calcification, and elevation of serum carbohydrate antigen (CA) 19-9 and CA 24-2. Three cases underwent retroperitoneal laparoscopic surgeries. Histopathologic examination confirmed the diagnosis of retroperitoneal bronchogenic cysts. There was no recurrence of the three cases during follow-up.
A retroperitoneal bronchogenic cyst is mostly asymptomatic. It can be found in adults with variable findings in computed tomography. It can be likely ignored and misdiagnosed as an adrenal tumor.
The tests of CA 19-9 and CA 24-2 could help diagnose retroperitoneal bronchogenic cysts. Retroperitoneal laparoscopic surgery is recommended for the treatment of retroperitoneal bronchogenic cysts with a favorable prognosis.
支气管源性囊肿是一种罕见的先天性气管支气管芽畸形,起源于原始前肠,尤其在腹膜后区域。成人腹膜后支气管源性囊肿术前难以准确诊断。
我们报告3例成人腹膜后支气管源性囊肿,形似肾上腺肿瘤。3例均无症状,且均位于左侧。对比增强计算机断层扫描显示囊肿壁无明显强化。2例在影像学上表现为典型的多房囊腔及散在钙化,而另1例表现为单房囊腔,无钙化,血清糖类抗原(CA)19-9和CA 24-2升高。3例均接受了腹膜后腹腔镜手术。组织病理学检查确诊为腹膜后支气管源性囊肿。3例随访期间均无复发。
腹膜后支气管源性囊肿大多无症状。在成人中可通过计算机断层扫描发现,表现多样。可能会被忽视并误诊为肾上腺肿瘤。
CA 19-9和CA 24-2检测有助于诊断腹膜后支气管源性囊肿。推荐采用腹膜后腹腔镜手术治疗腹膜后支气管源性囊肿,预后良好。