Bronchogenic cysts: clinicopathological presentation and treatment

The aim of this study was to evaluate the preoperative and operative presentations of one paediatric and 30 adult patients with bronchogenic cyst of the mediastinum (n = 11) and lung (n = 20). At initial presentation, six patients were asymptomatic and 25 were symptomatic. The mean age of asymptomatic and symptomatic patients was 25 and 33 yrs, respectively. Six patients presented with complications, including superior vena cava syndrome, tracheal compression, pneumothorax, pleurisy and pneumonia. Two patients who were asymptomatic when initially observed eventually needed surgery because of the development of symptoms or enlargement of the cyst size. In one patient, the cyst was not seen on the chest radiograph but appeared as a lobulated nodule of 2 cm diameter in a chest computerized tomography (CT) scan. Operative difficulties were encountered in 13 patients, all of whom were symptomatic preoperatively. In conclusion, life-threatening complications occurred in these patients. Despite various diagnostic studies, definitive tissue diagnosis was established only by means of surgical excision. The frequency of operative difficulties in symptomatic cysts was higher than those of asymptomatic cysts. Surgery may be considered as the treatment of choice even when the cyst is asymptomatic, since complications are not uncommon.