Li Fan-Fan, Li Xiao-Ping, Li Yong-Shun, Wang Xiao-Ping, Yang Xiao-Chun
Gansu University of Chinese Medicine, Lanzhou, Gansu 730000, China.
Department of Urology, Qing Shui County Hospital, Tian Shui, Gansu 741400, China.
Int J Surg Case Rep. 2025 Jun;131:111397. doi: 10.1016/j.ijscr.2025.111397. Epub 2025 May 1.
Bronchogenic cysts (BCs) are rare foregut-derived cystic malformations that can develop within the respiratory tract. While they are commonly found in the mediastinum or lungs, their occurrence at ectopic sites, such as the stomach, is extremely rare. This case report highlights the challenges in diagnosing a gastric bronchogenic cyst and the potential for misdiagnosis a pheochromocytoma, especially when associated with hypertension.
A 47-year-old male presented with a 6-day history of headache and nausea, and was found to have elevated blood pressure. Imaging studies, including computed tomography (CT) scans, suggested the possibility of a pheochromocytoma located near the left adrenal gland. However, subsequent surgical exploration revealed a cystic lesion near the posterior gastric wall, contiguous with the posterior gastric fundus. Pathological examination confirmed the diagnosis of a bronchogenic cyst in the gastric fundus.
Bronchogenic cysts are congenital malformations that can present diagnostic challenges, especially when located in atypical sites like the stomach or when associated with hypertension, potentially mimicking pheochromocytoma. Accurate diagnosis relies on imaging, laboratory tests for metanephrines, and careful clinical assessment to differentiate from other tumors.
Correct differentiation between gastric bronchogenic cysts and pheochromocytoma is crucial, emphasizing the need for thorough diagnostic workup and considerate surgical approach.
支气管源性囊肿(BCs)是罕见的源于前肠的囊性畸形,可在呼吸道内形成。虽然它们常见于纵隔或肺部,但在异位部位如胃中出现极为罕见。本病例报告强调了诊断胃支气管源性囊肿的挑战以及误诊为嗜铬细胞瘤的可能性,尤其是在伴有高血压的情况下。
一名47岁男性,有6天头痛和恶心病史,血压升高。包括计算机断层扫描(CT)在内的影像学检查提示左肾上腺附近可能存在嗜铬细胞瘤。然而,随后的手术探查发现胃后壁附近有一个囊性病变,与胃底后部相连。病理检查确诊为胃底支气管源性囊肿。
支气管源性囊肿是先天性畸形,可能带来诊断挑战,特别是当位于胃等非典型部位或与高血压相关时,可能会误诊为嗜铬细胞瘤。准确诊断依赖于影像学检查、甲氧基肾上腺素的实验室检测以及仔细的临床评估,以与其他肿瘤相鉴别。
正确区分胃支气管源性囊肿和嗜铬细胞瘤至关重要,强调了进行全面诊断检查和谨慎手术方法的必要性。