Subdiaphragmatic bronchogenic cysts: Case report and literature review.

INTRODUCTION AND IMPORTANCE

Bronchogenic cysts are rare congenital malformations of the respiratory tract, arising from abnormal budding of the foregut during embryogenesis. Clinical manifestations vary by location and complications, ranging from asymptomatic to causing respiratory distress in newborns or recurrent respiratory issues in adults. Subdiaphragmatic bronchogenic cysts are extremely rare, with only a limited number of case reports published. They often present without symptoms or with nonspecific symptoms such as abdominal pain. Diagnosis typically relies on histopathologic analysis of excised biopsies performed during surgery. Due to their rarity and lack of distinctive clinical features, these cysts pose significant diagnostic challenges.

CASE PRESENTATION

A 36-year-old Iranian man, presented with a 5-month history of abdominal pain. Abdominal sonography revealed a cystic lesion posterior to the liver. An aspiration biopsy indicated an inflammatory process. An abdominal CT scan without contrast reported a right subdiaphragmatic cyst measuring 68 × 52 × 48 mm with a pressure effect on the liver. The diagnosis was uncertain. The cyst was surgically removed, and histopathologic studies confirmed it to be a bronchogenic cyst. The patient had an uneventful recovery with no recurrence after six months.

CLINICAL DISCUSSION

In addition to presenting our case report, we reviewed recent literature and added 24 new cases to the previously identified 100 cases of subdiaphragmatic bronchogenic cysts. Subdiaphragmatic bronchogenic cysts are rare lesions with no specific presentation, making diagnosis extremely challenging.

CONCLUSION

SBC is a benign lesion. Most patients are asymptomatic; however, due to the favorable prognosis following resection surgery, it remains the optimal management strategy.