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单孔胸腔镜下切除误诊为神经源性肿瘤的支气管囊肿:一例报告

Uniportal thoracoscopic excision of a bronchogenic cyst impersonating neurogenic tumor: a case report.

作者信息

Sapkota Ranjan, Luitel Prajjwol, Tamang Manoj, Shrestha Asmita, Thapa Srijana

机构信息

Department of Cardio-Thoracic and Vascular Surgery, Manmohan Cardio-Thoracic Vascular and Transplant Centre, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.

Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.

出版信息

Ann Med Surg (Lond). 2025 Apr 15;87(6):3885-3888. doi: 10.1097/MS9.0000000000003273. eCollection 2025 Jun.

Abstract

INTRODUCTION

Mediastinal bronchogenic cysts (BC) comprise 50%-60% of all mediastinal cysts but are rare in the posterior mediastinum. The infrequent occurrence, unusual features, and atypical locations of posterior BC can result in misdiagnosis before surgery.

CASE PRESENTATION

A 37-year-old male presented with an incidental finding of paravertebral mass during his workup for renal cell carcinoma of the left kidney. Initially, the mass was diagnosed as a neurogenic tumor which after uniportal video-assisted thoracic surgery (uVATS) turned out to be a BC in an ectopic location.

DISCUSSION

Surgical resection is recommended for patients with symptoms and is sometimes indicated for asymptomatic patients to confirm diagnosis and prevent possible complications. The mediastinal BC was excised using uVATS, which being minimally invasive reduced the need for postoperative intensive care, minimized scarring, and shortened hospital stays.

CONCLUSION

BC can appear in atypical sites, which can lead to misdiagnosis. Surgical excision is the preferred treatment for these cysts. uVATS presents a safe method for definitive management in such cases.

摘要

引言

纵隔支气管源性囊肿(BC)占所有纵隔囊肿的50%-60%,但在后纵隔中较为罕见。后纵隔BC的发生率低、特征不寻常且位置不典型,可导致术前误诊。

病例报告

一名37岁男性在对左肾细胞癌进行检查时偶然发现椎旁肿块。最初,该肿块被诊断为神经源性肿瘤,经单孔电视辅助胸腔镜手术(uVATS)后发现是一个异位的BC。

讨论

有症状的患者建议手术切除,对于无症状患者,有时也需进行手术以确诊并预防可能的并发症。使用uVATS切除纵隔BC,该方法具有微创性,减少了术后重症监护的需求,使瘢痕最小化,并缩短了住院时间。

结论

BC可出现在非典型部位,这可能导致误诊。手术切除是这些囊肿的首选治疗方法。uVATS是此类病例确定性治疗的安全方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b5/12140685/b6bdc4f0da07/ms9-87-3885-g001.jpg

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