Thoracic Intracavitary Ultrasonographic Localization of a Mediastinal Bronchogenic Cyst

摘要

Bronchogenic cysts are rare developmental abnormalities, which necessitate surgical excision regardless of the presence of symptoms. Video-assisted thora-coscopic surgery (VATS) is the preferred surgical approach for cysts amenable to a minimally invasive approach. However, a VATS approach becomes technically more challenging with larger cysts and those that are located within the mediastinum, and conversion to thoracotomy may be required for safe dissection. Herein, we present a case in which a large (>5 cm) subcarinal bronchogenic cyst was safely excised with the aid of a laparoscopic ultrasound probe to identify a safe dissection plane. Use of ultrasound in such cases may help reduce the conversion rate to thoracotomy and improve patient outcomes. Bronchogenic cysts are a relatively rare congenital abnormality, which arise from abnormal foregut development during the first trimester. Although most bronchogenic cysts are asymptomatic, they may become symptomatic in adulthood if they become large enough to exert a mass effect on surrounding structures or if they become infected secondarily. Symptoms, if present, may include chest pain, dyspnea, dysphagia, cough, or a palpable neck lesion.1 Given that even asymptomatic bronchogenic cysts will likely develop symptoms or complications over time, the management of bronchogenic cysts is surgical excision whether or not symptoms are present.