Bouassida Imen, Hadj Dahmane Mariem, Zribi Hazem, Bessrour Habib, Hachicha Saber, Marghli Adel
Department of Thoracic Surgery, Abderrahmen Mami Hospital of Ariana, Tunisia.
Department of Thoracic Surgery, Abderrahmen Mami Hospital of Ariana, Tunisia.
Int J Surg Case Rep. 2023 May;106:108246. doi: 10.1016/j.ijscr.2023.108246. Epub 2023 Apr 25.
Bronchogenic cysts (BC) are congenital lesions, it results from an abnormal budding of the tracheobronchial tree. Malignant transformation is very rare. We report a case of adenocarcinoma arising in a BC of the posterior mediastinum detected after surgery.
We report the case of a 32-year-old man, without a particular medical history. The patient presented a cough associated with dyspnea, and a weight loss 4-month before the diagnosis. The imaging tools, showed a voluminous latero-tracheal mass of the posterior mediastinum. The diagnoses of a neurogenic tumor or a BC were suspected. The patient was treated by video-assisted thoracoscopy. Complete excision was done complicated by lesion's small rupture. The microscopic exam revealed unfortunately an adenocarcinoma arising in a BC. The patient had started the cure of chemotherapy. Six months later, the patient died due to tumor recurrence with cerebral metastasis.
Mediastinum BC, is usually located within the middle and posterior mediastinum. This condition is a benign congenital lesion. His curative therapy was a complete surgical resection with a good prognosis. However, malignant transformation may seldom occur and is most often accidentally diagnosed during the histological examination of specimens. In this case, the surgical treatment may be insufficient, and the prognosis may be poor.
Malignant degeneration of mediastinal BC, despite being rare, should be kept in mind, carefully avoided and managed.
支气管源性囊肿（BC）是先天性病变，由气管支气管树的异常芽生所致。恶性转化非常罕见。我们报告1例术后发现的后纵隔支气管源性囊肿内发生腺癌的病例。
我们报告1例32岁男性，无特殊病史。患者在诊断前4个月出现咳嗽伴呼吸困难及体重减轻。影像学检查显示后纵隔有一巨大的气管旁肿物。怀疑为神经源性肿瘤或支气管源性囊肿。患者接受了电视辅助胸腔镜手术。完整切除肿物，但术中肿物有小破裂。不幸的是，显微镜检查显示为支气管源性囊肿内发生腺癌。患者开始化疗。6个月后，患者因肿瘤复发伴脑转移死亡。
纵隔支气管源性囊肿通常位于中纵隔和后纵隔。这种情况是一种良性先天性病变。其根治性治疗是完整手术切除，预后良好。然而，恶性转化很少发生，且大多在标本组织学检查时意外诊断。在这种情况下，手术治疗可能不足，预后可能较差。
纵隔支气管源性囊肿的恶性变虽罕见，但应牢记，需谨慎避免并妥善处理。
