Retroperitoneal bronchogenic cyst: a rare case report

Retroperitoneal bronchogenic cyst: a rare case report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Retroperitoneal bronchogenic cyst: a rare case report Yufeng Fan, Xiaogang Zhu, Rongjin Wang, Weigang Yang, Xiaoliang Ji, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4263770/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Although abdominal cysts are frequently observed, retroperitoneal bronchogenic cysts (RBCs) are rare. We encountered a patient with RBC who underwent a series of examinations and surgical resections and was followed up for 5 years. Case presentation A 31-year-old woman presented to our center with abdominal trauma. Transabdominal ultrasonography (TAUS) inadvertently revealed a cystic lesion in the left upper quadrant, and computed tomography (CT) revealed a large homogeneous fluid-density lesion, which was tentatively diagnosed as a cystic teratoma. Neither ultrasound nor CT showed signs of abdominal organ damage. The patient underwent laparoscopic resection, and the lesion was removed entirely. The histopathology diagnosis was RBC. Conclusions Retroperitoneal bronchial cysts are rare and usually clinically asymptomatic. Although rare, retroperitoneal bronchial cysts should be considered in the differential diagnosis of patients with abdominal cystic masses. Imaging examinations, such as ultrasound and CT, are the main ways to detect the disease. Laparoscopyis a feasible and safe treatment for RBCs. Bronchogenic cyst Retroperitoneal Adult Case report Diagnosis Laparoscopic surgery Figures Figure 1 Figure 2 Figure 3 Figure 4 Background Bronchogenic cysts are rare congenital lesions that often occur in the mediastinum and sometimes in the lung parenchyma, diaphragm, and pleura [ 1 ] . Bronchogenic cysts can occur in patients of various ages, but they most commonly occur before the age of 40 [ 2 ] . It rarely occurs in the retroperitoneal space [ 3 ] . Most RBCs are single, and a few are multiple [ 1 , 4 ] . Patients with RBC often lack characteristic symptoms, which may only be discovered occasionally through physical examination or image analysis [ 5 ] . These tumors are often misdiagnosed as teratomas, lymphocytic cysts, etc, if we analyze them purely based on their imaging features [ 2 , 5 ] . Surgical resection is currently the preferred treatment strategy for RBCs [ 6 ] . However, this is not easy, especially as the cysts develop near vital organs, such as the pancreas and abdominal aorta. We herein present a patient who was unexpectedly diagnosed with this condition due to abdominal trauma and was successfully treated. Case presentation A 31-year-old female patient visited the hospital due to abdominal trauma, without epigastric pain, weight loss, nausea, vomiting, fever, etc. The patient denied any family or personal history of malignant tumors, endocrine tumors, hypertension, or other heredity or infection. The physical examination results were not noticeable. TAUS and Color Doppler flow imaging (CDFI) revealed a cystic mass in the left upper quadrant. The lesion was deep and close to the aorta, spinal column, and stomach. It showed an irregularly shaped mass, measuring 7.8×4.7×4.3 cm 3 , with a homogeneous content, thin wall, well-defined, and several "thin hyperechoic line" signs of septation without internal papillae. There was also a fluid-fluid layer in the middle portion of the lesion (Fig. 1 A). There was some calcification in the septations of the lesion without noticeable shadows (Fig. 1 B). CDFI demonstrated no enhancement of the mass or septations (Fig. 1 C). Upper abdominal CECT revealed that it was possibly fused to the diaphragmatic muscle. However, the boundary was clear (Fig. 2 A). Similarly, CECT revealed no enhancement of the mass or septum, no prominent lymphadenopathy in the retroperitoneal space, and no liver metastasis (Fig. 2 B). The pancreas and stomach were displaced forward, and the splenic artery was displaced downward (Fig. 2 C). Neither ultrasound nor CT showed signs of abdominal organ damage. The laboratory results, including complete blood count, hepatic and renal function, catecholamine, epinephrine, norepinephrine, dopamine, metanephrine, normetanephrine, and tumor marker (CA-125, CA-199, AFP, CEA, etc.), were within the normal ranges. Due to the large size of the mass and its proximity to essential organs, the surgeon considered exploratory laparoscopic surgery to be a reasonable and necessary treatment strategy, and the patient provided written informed consent. The lesion was located in the superior retroperitoneal region and fused to the diaphragmatic muscle and less omentum, as expected from preoperative imaging studies. The anterior margin of the lesion was dissociative (Fig. 3 A). The mass was adjacent to the pancreas and stomach, pushing them ahead (Fig. 3 B). The boundary between the left adrenal gland and the mass was clear. Fortunately, the mass was entirely surgically resected within 2 hours (Fig. 3 C). The gross specimen of the resected mass was gray-brown with a size of 7.5×5.0×4.5 cm 3 (Fig. 3 C). The clump contains yellow-brown oily fluid and gray mucus. Histopathological examination revealed that the cyst wall was lined with squamous epithelial cells (Fig. 4 A) and mature hyaline cartilage (Fig. 4 B). The diagnosis of RBC is established based on histopathology. The operation and postoperative procedures proceeded smoothly, and the patient was discharged from the hospital five days later. A follow-up examination revealed that the patient was in good health five years after the operation, without evidence of recurrence. Discussion Bronchogenic cysts are usually benign congenital abnormalities resulting from the primitive foregut. The cyst wall is lined with pseudostratified ciliated columnar epithelium, smooth muscle cells, bronchial glands, or cartilage [ 1 , 7 ] . Bronchogenic cysts commonly originate from the pleural mediastinum, occasionally in subcutaneous tissue, the pericardium, or the spinal canal, and rarely in the retroperitoneal space [ 1 , 8 , 9 ] . The exact pathogenesis of RBC remains unclear. Sumiyoshi et al. [ 10 ] hypothesized that cysts originate from the septum and migration of the lung bud. Due to embryological development in the primitive foregut, the RBC comprises mesodermal and endodermal tissue [ 11 ] . Govaerts et al. [ 12 ] reported that 76% of RBCs are located in the pericardium's upper left space. Due to the large potential for retroperitoneal space, RBCs can grow considerably without obvious symptoms [ 1 ] . Hence, patients typically discover RBCs by accident. RBCs are located close to surrounding tissues, including the kidney and pancreas, so the disease can easily be misdiagnosed as teratoma, hemorrhagic cyst, liposarcoma, or lymphocele [ 2 , 5 , 13 , 14 ] . However, with the development of radiological technology, the number of accidental discoveries of asymptomatic RBCs has rapidly increased [ 5 ] . CT is helpful in the diagnosis of RBCs and can overcome the trouble of gastrointestinal gas interference. CECT scans are used to evaluate the lesion shape, characteristics of the wall, adjacent structures, location, attenuation, homogeneity, calcification, and enhancement pattern [ 2 , 15 ] . CT typically detects RBCs as well-defined spherical lobular lesions, as in the current case. CT sometimes shows a "fluid-fluid" level sign within the cyst, which is helpful for diagnosis [ 16 ] . However, RBCs often appear as heterogeneous or homogenous, hypoattenuating lesions, which are easily misdiagnosed as soft-tissue lesions. Based on the density of lesions on CT scans, RBCs can be classified as cystic lesions, solid lesions, or lesions of uncertain classification. (1) Cystic lesions: The attenuation of the lesions is less than that of the surrounding soft tissue, the interior is uniform, there is no internal enhancement, and the cyst wall is demarcated. (2) Solid lesion: The attenuation of the lesion is similar to that of the surrounding soft tissue, the interior is uneven, and there is no clear thin wall. (3) Lesions with uncertain classification: those whose CT characteristics do not meet the above symptoms. MR imaging can help visualize the cystic component of lesions that appear solid or indeterminate on CT, which can help increase the diagnostic confidence for RBCs. The fluid in an RBC is typically a mixture of water and protein mucus. MRI can easily distinguish whether the lesion is cystic and shows high signal intensity on T2-weighted images (T2WIs), but a small number of RBCs are solid or mixed, which can make diagnosis difficult [ 2 , 16 ] . Ultrasonography can easily distinguish whether the lesions are cystic or not, which helps to diagnose RBCs. However, the value of TAUS in the diagnosis of RBCs is disputable because of its deep location and interference from gastrointestinal gas [ 8 , 13 ] . EBUS can be used for diagnosis and aspiration when the lesion is in the mediastinum or bronchi, and the “ fluid-thrill ” sign on EBUS helps to diagnose bronchogenic cysts. EUBS-TBNA has become a standard procedure for obtaining biopsies for mediastinal disorders [ 17 ] . Regrettably, EBUS is ineffective in diagnosing RBCs. The treatment strategy for RBCs is based on their nature and location, and laparoscopic excision is the preferred and safest method [ 18 , 19 ] . Although RBCs are often asymptomatic, considering the potential complications associated with surgical resection and the risk of malignant transformation [ 20 ] , they should be removed early. Conclusions In short, RBCs are rare. It is usually found by chance via radiographic analysis. Imaging techniques, such as ultrasound, CT, and MRI, are typically effective for detecting RBCs but are easily misdiagnosed. MRI helps to locate the lesion and identify the nature of the cyst, which allows the identification of solid lesions. However, it is difficult to determine a precise diagnosis by imaging alone before surgery. Histopathological analysis is necessary for clarification. Nevertheless, RBCs should be considered in the differential diagnosis of patients with abdominal cystic masses. Surgical removal is the most effective method for treating this disease. Laparoscopy is a feasible and safe treatment for RBCs. Abbreviations RBC: Retroperitoneal bronchogenic cyst TAUS: Transabdominal ultrasonography CDFI: Color Doppler flow imaging CT: Computed Tomography CECT: Contrast-enhanced computed tomography EBUS: Endobronchial ultrasound EBUS-TBNA: Endobronchial ultrasound-guided transbronchial needle aspiration MRI: Magnetic Resonance Imaging Declarations Ethics approval and consent to participat ion Not applicable. Consent to Publish Declaration: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-In-Chief of this journal. Availability of data and materials The original contributions presented in the study are included in the article /supplementary material. Further inquiries can be directed to the corresponding author. Competing interests The authors declare no competing interests. Funding There are no sources of funding. Author s ’ contributions YF, WY, XJ, and MJ obtained the data and treated the patient.YF wrote the main manuscript.XZ revised the paper. RW and XZ prepared Fig. 1. MZ prepared Fig. 2. YF and WY prepared Fig. 3. YH prepared Fig. 4. All the authors wrote part of the text and read and approved the final manuscript. Acknowledgments Not applicable. References Gross DJ, Briski LM, Wherley EM, Nguyen DM. Bronchogenic cysts: a narrative review. Mediastinum (Hong Kong China). 2023;7:26. McAdams HP, Kirejczyk WM, Rosado-de-Christenson ML, Matsumoto S. Bronchogenic cyst: imaging features with clinical and histopathologic correlation. Radiology. 2000;217:441–6. Núñez-Rocha RE, Pérez V, Urango ML, Mejía M, Palau M, Herrera-Almario G. Extrapulmonary bronchogenic cyst: A case report. Int J Surg Case Rep. 2023;110:108706. Atoini F, Ouarssani A, Ouadnouni Y, Smahi M. Unusual mode of presentation of intrathoracic bronchogenic cyst: A double location. Respir Med Case Rep. 2016;17:12–6. Gu X, Zhu L, Li Y, Yin B, Wang Z. Imaging Findings and Misdiagnosis of Bronchogenic Cysts: A Study of 83 Cases. J Belg Soc Radiol. 2023;107:81. de Barcellos Azambuja D, Oliveira Trindade B, Valdeci Worm P, Hassan Hamaoui F, Iaroseski J. Retrorectal Bronchogenic Cyst With a Sacrococcygeal Surgical Approach. Cureus. 2022;14:e31583. Onishi Y, Kawabata S, Yasuda E, Ibuki N, Azuma H, Hirota Y, et al. Bronchogenic cysts in rare sites (retroperitoneum, skin, spinal cord and pericardial cavity): A case series and characterization of epithelial phenotypes. Biomedical Rep. 2024;20:21. Ooi KM, Saniasiaya J, Kulasegarah J, Ong DL. Cervical bronchogenic cyst in a toddler. BMJ case Rep. 2024; 17. Rahman SMT, Islam MM, Akhter KM, Islam MZ, Hossain M. Bronchogenic cyst at unusual location. Respir Med Case Rep. 2023;46:101947. Sumiyoshi K, Shimizu S, Enjoji M, Iwashita A, Kawakami K. Bronchogenic cyst in the abdomen. Virchows Archiv A, Pathological anatomy and histopathology. 1985; 408:93–8. Geng YH, Wang CX, Li JT, Chen QY, Li XZ, Pan H. Gastric foregut cystic developmental malformation: case series and literature review. World J Gastroenterol. 2015;21:432–8. Govaerts K, Van Eyken P, Verswijvel G, Van der Speeten K. A bronchogenic cyst, presenting as a retroperitoneal cystic mass. Rare tumors. 2012;4:e13. Idrees H, Zarrar R, Taslicay CA, Elsayes KM. Retroperitoneal bronchogenic cyst mimicking an adrenal cyst: case report. BJR Case Rep. 2024;10:uaad001. Yang B, Liu L, Tian X, Hou X, Lu M, Ma L. Retroperitoneal bronchogenic cyst resembling an adrenal tumor in adult: Three case reports and literature review. Annals of medicine and surgery (2012). 2023; 85:473-6. Qingyu J, Xiaolong L, Ruohan Z, Licong M, Zhichao T, Qingwei C, et al. Computed tomography helps pre-operative evaluation before laparoscopic resection of retroperitoneal bronchogenic cyst: A case report. J Minim Access Surg. 2021;17:95–7. Xie W, Huang Z, Huang Z, Chen Z, Zhang B, Xie L, et al. Retroperitoneal bronchogenic cyst with fluid–fluid level: A case report and literature review. Experimental therapeutic Med. 2023;25:5. Kundu U, Gan Q, Donthi D, Sneige N. The Utility of Fine Needle Aspiration (FNA) Biopsy in the Diagnosis of Mediastinal Lesions. Diagnostics (Basel). 2023; 13. Li H, Xu J, Feng Q, Cai Z, Li J. Case report: The safety of laparoscopic surgery for the retroperitoneal bronchogenic cyst. Front Oncol. 2022;12:1011076. Tadokoro T, Misumi T, Itamoto T, Nakahara H, Matsugu Y, Ikeda S, et al. Retroperitoneal Bronchogenic Cyst Resected by Single-Incision Laparoscopic Surgery in an Adolescent Female: A Case Report. Asian J Endosc Surg. 2022;15:206–10. Sullivan SM, Okada S, Kudo M, Ebihara Y. A retroperitoneal bronchogenic cyst with malignant change. Pathol Int. 1999;49:338–41. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4263770","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":291758076,"identity":"3bf281f3-1dd4-4253-a96c-af720d5a3ae7","order_by":0,"name":"Yufeng Fan","email":"","orcid":"","institution":"Huzhou Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang Chinese Medical University,Huzhou","correspondingAuthor":false,"prefix":"","firstName":"Yufeng","middleName":"","lastName":"Fan","suffix":""},{"id":291758077,"identity":"96054693-afd1-4177-b20b-17765e390a06","order_by":1,"name":"Xiaogang Zhu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAtElEQVRIiWNgGAWjYDCCAwxsIEqOjb39AGlajPl4ziSQpiVxnoSDAXE6+G4ff/aYt602vU2CIYHhR8U2wlokzyWkG/OcOZ7bJt14gLHnzG3CWgzOMByT5qk4ltsmcyCBmbGNKC2MbdI8BsfS2SQSDIjVwswGtKUmgXgtkmfY2CTnnDlg2AYM5INE+YXvDPszibdtdfLy7e0HH/yoIEILFBwGkweIVg8EdaQoHgWjYBSMgpEGAB3/OmI+n65vAAAAAElFTkSuQmCC","orcid":"","institution":"Huzhou Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang Chinese Medical University,Huzhou","correspondingAuthor":true,"prefix":"","firstName":"Xiaogang","middleName":"","lastName":"Zhu","suffix":""},{"id":291758078,"identity":"eabe8a35-7d48-4319-979d-236340a687b6","order_by":2,"name":"Rongjin Wang","email":"","orcid":"","institution":"Huzhou Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang Chinese Medical University,Huzhou","correspondingAuthor":false,"prefix":"","firstName":"Rongjin","middleName":"","lastName":"Wang","suffix":""},{"id":291758079,"identity":"4f1921c8-e5a6-4027-8f7f-31c5462a4c10","order_by":3,"name":"Weigang Yang","email":"","orcid":"","institution":"Huzhou City Wuxing District Integrated Traditional Chinese and Western Medicine Hospital,Huzhou","correspondingAuthor":false,"prefix":"","firstName":"Weigang","middleName":"","lastName":"Yang","suffix":""},{"id":291758082,"identity":"8b0187b5-d705-4f78-8aef-7d9891377c58","order_by":4,"name":"Xiaoliang Ji","email":"","orcid":"","institution":"Huzhou Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang Chinese Medical University,Huzhou","correspondingAuthor":false,"prefix":"","firstName":"Xiaoliang","middleName":"","lastName":"Ji","suffix":""},{"id":291758083,"identity":"7d955763-9c7f-42e3-9cbf-c09f0321d13a","order_by":5,"name":"Mingdong Zhuang","email":"","orcid":"","institution":"Huzhou Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang Chinese Medical University,Huzhou","correspondingAuthor":false,"prefix":"","firstName":"Mingdong","middleName":"","lastName":"Zhuang","suffix":""},{"id":291758084,"identity":"6577801a-e9ab-45e8-9ffa-c63fa1505e59","order_by":6,"name":"Ming Jiang","email":"","orcid":"","institution":"Huzhou Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang Chinese Medical University,Huzhou","correspondingAuthor":false,"prefix":"","firstName":"Ming","middleName":"","lastName":"Jiang","suffix":""},{"id":291758086,"identity":"0c8c32f6-6bdc-47d1-91d6-e85aa1c38f25","order_by":7,"name":"Yun Hu","email":"","orcid":"","institution":"Huzhou Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang Chinese Medical University,Huzhou","correspondingAuthor":false,"prefix":"","firstName":"Yun","middleName":"","lastName":"Hu","suffix":""}],"badges":[],"createdAt":"2024-04-14 06:14:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4263770/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4263770/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":55321784,"identity":"7c517409-5c89-4c42-8e49-48f7a8b5b912","added_by":"auto","created_at":"2024-04-25 16:23:52","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":6183411,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eImaging at admission. \u003c/strong\u003e(A) Ultrasonography (USG) scan indicated an irregularly shaped mass in the upper retroperitoneal region. Note the dependent anechoic cystic mass attenuating material (red arrow). Note a fluid-fluid layer in the middle portion of the lesion (white arrow). (B) Calcification (blue arrow) in the septations of the lesion. (C) Color Doppler flow imaging (CDFI) demonstrated the mass had no blood supply. (CA: cardiac, LL: left liver, LK: left kidney, I: inferior vena cave, Sp: spine, a: aorta, m: mass)\u003c/p\u003e","description":"","filename":"Figure1Imagingatadmission.png","url":"https://assets-eu.researchsquare.com/files/rs-4263770/v1/a1e0f8adc236f6733a2c5db8.png"},{"id":55321782,"identity":"d33d964d-66a1-4596-93c7-6fa1c29870bc","added_by":"auto","created_at":"2024-04-25 16:23:51","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":4931530,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eImaging at admission. \u003c/strong\u003e(A) Computed tomography (CT) scan indicated an irregularly-shaped mass in the left retroperitoneal region. Note the calcification in the wall of the lesion (red arrow). (B) Contrast-enhanced CT (CECT) demonstrated no enhancement of the mass and septations. (C) Coronary CT showed that the mass was between the abdominal aorta and the stomach. The splenic artery was compressed and displaced downward ( blue arrow: splenic artery). ( RL: right liver, LL: left liver, sto: stomach, m: mass, yellow arrow: adrenal gland )\u003c/p\u003e","description":"","filename":"Figure2Imagingatadmission.png","url":"https://assets-eu.researchsquare.com/files/rs-4263770/v1/3f8a5a94501c23bf60ae865f.png"},{"id":55321783,"identity":"ab8725d5-2b85-4d0e-b893-71afda173564","added_by":"auto","created_at":"2024-04-25 16:23:51","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":7762460,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eImaging during the operation \u003c/strong\u003e(A) The RBC pushed the stomach aside and stuck to each other. (B) Cut the lesser omental sac to expose the mass. (C) The mass is completely removed and the size is about 7.5×5.0×4.5cm ( blue arrow) ( M: mass, Sto: stomach, LL: left liver )\u003c/p\u003e","description":"","filename":"Figure3Imagingduringtheoperation.png","url":"https://assets-eu.researchsquare.com/files/rs-4263770/v1/54f8d5c112a3d1d6a99efa30.png"},{"id":55322847,"identity":"c3826585-467b-4db8-bcba-75e6507c5fde","added_by":"auto","created_at":"2024-04-25 16:31:52","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":15817440,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePostoperative histopathology.\u003c/strong\u003e Microscopic view of the retroperitoneal bronchogenic cyst (RBC). (A) The mass contained fibrous connective tissue (black arrow) pseudostratified ciliated columnar epithelium (red arrow) and a Blue box in the upper left corner of Figure A: partially enlarged view of the lesion. ( Hematoxylin and eosin staining; magnification ×100 ) \u0026nbsp;(B) A partial area of the lesion contains mature hyaline cartilage (blue arrow) (HE; magnification ×40)\u003c/p\u003e","description":"","filename":"Figure4Postoperativehistopathology.png","url":"https://assets-eu.researchsquare.com/files/rs-4263770/v1/558b2d2038e684b17fa11b0f.png"},{"id":55438257,"identity":"1020b58e-08aa-46c8-8cd0-6aa551738e8a","added_by":"auto","created_at":"2024-04-27 17:00:54","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2810061,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4263770/v1/f4de17c0-c591-4cfa-95f3-057320bd7b68.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Retroperitoneal bronchogenic cyst: a rare case report","fulltext":[{"header":"Background","content":"\u003cp\u003eBronchogenic cysts are rare congenital lesions that often occur in the mediastinum and sometimes in the lung parenchyma, diaphragm, and pleura \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. Bronchogenic cysts can occur in patients of various ages, but they most commonly occur before the age of 40 \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. It rarely occurs in the retroperitoneal space \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e. Most RBCs are single, and a few are multiple \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. Patients with RBC often lack characteristic symptoms, which may only be discovered occasionally through physical examination or image analysis \u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. These tumors are often misdiagnosed as teratomas, lymphocytic cysts, etc, if we analyze them purely based on their imaging features \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eSurgical resection is currently the preferred treatment strategy for RBCs \u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e. However, this is not easy, especially as the cysts develop near vital organs, such as the pancreas and abdominal aorta.\u003c/p\u003e \u003cp\u003eWe herein present a patient who was unexpectedly diagnosed with this condition due to abdominal trauma and was successfully treated.\u003c/p\u003e"},{"header":"Case presentation","content":"\u003cp\u003eA 31-year-old female patient visited the hospital due to abdominal trauma, without epigastric pain, weight loss, nausea, vomiting, fever, etc. The patient denied any family or personal history of malignant tumors, endocrine tumors, hypertension, or other heredity or infection. The physical examination results were not noticeable.\u003c/p\u003e \u003cp\u003eTAUS and Color Doppler flow imaging (CDFI) revealed a cystic mass in the left upper quadrant. The lesion was deep and close to the aorta, spinal column, and stomach. It showed an irregularly shaped mass, measuring 7.8\u0026times;4.7\u0026times;4.3 cm\u003csup\u003e3\u003c/sup\u003e, with a homogeneous content, thin wall, well-defined, and several \"thin hyperechoic line\" signs of septation without internal papillae. There was also a fluid-fluid layer in the middle portion of the lesion (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eA). There was some calcification in the septations of the lesion without noticeable shadows (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eB). CDFI demonstrated no enhancement of the mass or septations (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eC).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eUpper abdominal CECT revealed that it was possibly fused to the diaphragmatic muscle. However, the boundary was clear (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eA). Similarly, CECT revealed no enhancement of the mass or septum, no prominent lymphadenopathy in the retroperitoneal space, and no liver metastasis (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eB). The pancreas and stomach were displaced forward, and the splenic artery was displaced downward (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eC). Neither ultrasound nor CT showed signs of abdominal organ damage.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe laboratory results, including complete blood count, hepatic and renal function, catecholamine, epinephrine, norepinephrine, dopamine, metanephrine, normetanephrine, and tumor marker (CA-125, CA-199, AFP, CEA, etc.), were within the normal ranges.\u003c/p\u003e \u003cp\u003eDue to the large size of the mass and its proximity to essential organs, the surgeon considered exploratory laparoscopic surgery to be a reasonable and necessary treatment strategy, and the patient provided written informed consent. The lesion was located in the superior retroperitoneal region and fused to the diaphragmatic muscle and less omentum, as expected from preoperative imaging studies. The anterior margin of the lesion was dissociative (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eA). The mass was adjacent to the pancreas and stomach, pushing them ahead (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eB). The boundary between the left adrenal gland and the mass was clear. Fortunately, the mass was entirely surgically resected within 2 hours (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eC).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe gross specimen of the resected mass was gray-brown with a size of 7.5\u0026times;5.0\u0026times;4.5 cm\u003csup\u003e3\u003c/sup\u003e (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eC). The clump contains yellow-brown oily fluid and gray mucus. Histopathological examination revealed that the cyst wall was lined with squamous epithelial cells (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003eA) and mature hyaline cartilage (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003eB). The diagnosis of RBC is established based on histopathology.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe operation and postoperative procedures proceeded smoothly, and the patient was discharged from the hospital five days later. A follow-up examination revealed that the patient was in good health five years after the operation, without evidence of recurrence.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eBronchogenic cysts are usually benign congenital abnormalities resulting from the primitive foregut. The cyst wall is lined with pseudostratified ciliated columnar epithelium, smooth muscle cells, bronchial glands, or cartilage \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e. Bronchogenic cysts commonly originate from the pleural mediastinum, occasionally in subcutaneous tissue, the pericardium, or the spinal canal, and rarely in the retroperitoneal space \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe exact pathogenesis of RBC remains unclear. Sumiyoshi et al. \u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e hypothesized that cysts originate from the septum and migration of the lung bud. Due to embryological development in the primitive foregut, the RBC comprises mesodermal and endodermal tissue \u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e. Govaerts et al. \u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e reported that 76% of RBCs are located in the pericardium's upper left space.\u003c/p\u003e \u003cp\u003eDue to the large potential for retroperitoneal space, RBCs can grow considerably without obvious symptoms \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. Hence, patients typically discover RBCs by accident. RBCs are located close to surrounding tissues, including the kidney and pancreas, so the disease can easily be misdiagnosed as teratoma, hemorrhagic cyst, liposarcoma, or lymphocele \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e. However, with the development of radiological technology, the number of accidental discoveries of asymptomatic RBCs has rapidly increased \u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eCT is helpful in the diagnosis of RBCs and can overcome the trouble of gastrointestinal gas interference. CECT scans are used to evaluate the lesion shape, characteristics of the wall, adjacent structures, location, attenuation, homogeneity, calcification, and enhancement pattern \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e. CT typically detects RBCs as well-defined spherical lobular lesions, as in the current case. CT sometimes shows a \"fluid-fluid\" level sign within the cyst, which is helpful for diagnosis \u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e. However, RBCs often appear as heterogeneous or homogenous, hypoattenuating lesions, which are easily misdiagnosed as soft-tissue lesions.\u003c/p\u003e \u003cp\u003eBased on the density of lesions on CT scans, RBCs can be classified as cystic lesions, solid lesions, or lesions of uncertain classification. (1) Cystic lesions: The attenuation of the lesions is less than that of the surrounding soft tissue, the interior is uniform, there is no internal enhancement, and the cyst wall is demarcated. (2) Solid lesion: The attenuation of the lesion is similar to that of the surrounding soft tissue, the interior is uneven, and there is no clear thin wall. (3) Lesions with uncertain classification: those whose CT characteristics do not meet the above symptoms.\u003c/p\u003e \u003cp\u003eMR imaging can help visualize the cystic component of lesions that appear solid or indeterminate on CT, which can help increase the diagnostic confidence for RBCs. The fluid in an RBC is typically a mixture of water and protein mucus. MRI can easily distinguish whether the lesion is cystic and shows high signal intensity on T2-weighted images (T2WIs), but a small number of RBCs are solid or mixed, which can make diagnosis difficult \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eUltrasonography can easily distinguish whether the lesions are cystic or not, which helps to diagnose RBCs. However, the value of TAUS in the diagnosis of RBCs is disputable because of its deep location and interference from gastrointestinal gas \u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e. EBUS can be used for diagnosis and aspiration when the lesion is in the mediastinum or bronchi, and the \u0026ldquo; fluid-thrill \u0026rdquo; sign on EBUS helps to diagnose bronchogenic cysts. EUBS-TBNA has become a standard procedure for obtaining biopsies for mediastinal disorders \u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e. Regrettably, EBUS is ineffective in diagnosing RBCs.\u003c/p\u003e \u003cp\u003eThe treatment strategy for RBCs is based on their nature and location, and laparoscopic excision is the preferred and safest method \u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e. Although RBCs are often asymptomatic, considering the potential complications associated with surgical resection and the risk of malignant transformation \u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e, they should be removed early.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn short, RBCs are rare. It is usually found by chance via radiographic analysis. Imaging techniques, such as ultrasound, CT, and MRI, are typically effective for detecting RBCs but are easily misdiagnosed. MRI helps to locate the lesion and identify the nature of the cyst, which allows the identification of solid lesions. However, it is difficult to determine a precise diagnosis by imaging alone before surgery. Histopathological analysis is necessary for clarification. Nevertheless, RBCs should be considered in the differential diagnosis of patients with abdominal cystic masses. Surgical removal is the most effective method for treating this disease. Laparoscopy is a feasible and safe treatment for RBCs.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eRBC: Retroperitoneal bronchogenic cyst\u003c/p\u003e\n\u003cp\u003eTAUS: Transabdominal ultrasonography\u003c/p\u003e\n\u003cp\u003eCDFI: Color Doppler flow imaging\u003c/p\u003e\n\u003cp\u003eCT: Computed Tomography\u003c/p\u003e\n\u003cp\u003eCECT: Contrast-enhanced computed tomography\u003c/p\u003e\n\u003cp\u003eEBUS: Endobronchial ultrasound\u003c/p\u003e\n\u003cp\u003eEBUS-TBNA: Endobronchial ultrasound-guided transbronchial needle aspiration\u003c/p\u003e\n\u003cp\u003eMRI: Magnetic Resonance Imaging\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participat\u003c/strong\u003e\u003cstrong\u003eion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to Publish Declaration:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from the patient for publication of\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ethis case report and any accompanying images. A copy of the written consent\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eis available for review by the Editor-In-Chief of this journal.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe original contributions presented in the study are included in the article /supplementary material. Further inquiries can be directed to the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere are no sources of funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor\u003c/strong\u003e\u003cstrong\u003es\u003c/strong\u003e\u003cstrong\u003e\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYF, WY, XJ, and MJ obtained the data and treated the patient.YF wrote the main manuscript.XZ revised the paper. RW and XZ prepared Fig. 1. MZ prepared Fig. 2. YF and WY prepared Fig. 3. YH prepared Fig. 4. All the authors wrote part of the text and read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eGross DJ, Briski LM, Wherley EM, Nguyen DM. Bronchogenic cysts: a narrative review. Mediastinum (Hong Kong China). 2023;7:26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMcAdams HP, Kirejczyk WM, Rosado-de-Christenson ML, Matsumoto S. Bronchogenic cyst: imaging features with clinical and histopathologic correlation. Radiology. 2000;217:441\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eN\u0026uacute;\u0026ntilde;ez-Rocha RE, P\u0026eacute;rez V, Urango ML, Mej\u0026iacute;a M, Palau M, Herrera-Almario G. Extrapulmonary bronchogenic cyst: A case report. Int J Surg Case Rep. 2023;110:108706.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAtoini F, Ouarssani A, Ouadnouni Y, Smahi M. Unusual mode of presentation of intrathoracic bronchogenic cyst: A double location. Respir Med Case Rep. 2016;17:12\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGu X, Zhu L, Li Y, Yin B, Wang Z. Imaging Findings and Misdiagnosis of Bronchogenic Cysts: A Study of 83 Cases. J Belg Soc Radiol. 2023;107:81.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ede Barcellos Azambuja D, Oliveira Trindade B, Valdeci Worm P, Hassan Hamaoui F, Iaroseski J. Retrorectal Bronchogenic Cyst With a Sacrococcygeal Surgical Approach. Cureus. 2022;14:e31583.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOnishi Y, Kawabata S, Yasuda E, Ibuki N, Azuma H, Hirota Y, et al. Bronchogenic cysts in rare sites (retroperitoneum, skin, spinal cord and pericardial cavity): A case series and characterization of epithelial phenotypes. Biomedical Rep. 2024;20:21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOoi KM, Saniasiaya J, Kulasegarah J, Ong DL. Cervical bronchogenic cyst in a toddler. BMJ case Rep. 2024; 17.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRahman SMT, Islam MM, Akhter KM, Islam MZ, Hossain M. Bronchogenic cyst at unusual location. Respir Med Case Rep. 2023;46:101947.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSumiyoshi K, Shimizu S, Enjoji M, Iwashita A, Kawakami K. Bronchogenic cyst in the abdomen. Virchows Archiv A, Pathological anatomy and histopathology. 1985; 408:93\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGeng YH, Wang CX, Li JT, Chen QY, Li XZ, Pan H. Gastric foregut cystic developmental malformation: case series and literature review. World J Gastroenterol. 2015;21:432\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGovaerts K, Van Eyken P, Verswijvel G, Van der Speeten K. A bronchogenic cyst, presenting as a retroperitoneal cystic mass. Rare tumors. 2012;4:e13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIdrees H, Zarrar R, Taslicay CA, Elsayes KM. Retroperitoneal bronchogenic cyst mimicking an adrenal cyst: case report. BJR Case Rep. 2024;10:uaad001.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYang B, Liu L, Tian X, Hou X, Lu M, Ma L. Retroperitoneal bronchogenic cyst resembling an adrenal tumor in adult: Three case reports and literature review. Annals of medicine and surgery (2012). 2023; 85:473-6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eQingyu J, Xiaolong L, Ruohan Z, Licong M, Zhichao T, Qingwei C, et al. Computed tomography helps pre-operative evaluation before laparoscopic resection of retroperitoneal bronchogenic cyst: A case report. J Minim Access Surg. 2021;17:95\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXie W, Huang Z, Huang Z, Chen Z, Zhang B, Xie L, et al. Retroperitoneal bronchogenic cyst with fluid\u0026ndash;fluid level: A case report and literature review. Experimental therapeutic Med. 2023;25:5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKundu U, Gan Q, Donthi D, Sneige N. The Utility of Fine Needle Aspiration (FNA) Biopsy in the Diagnosis of Mediastinal Lesions. Diagnostics (Basel). 2023; 13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi H, Xu J, Feng Q, Cai Z, Li J. Case report: The safety of laparoscopic surgery for the retroperitoneal bronchogenic cyst. Front Oncol. 2022;12:1011076.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTadokoro T, Misumi T, Itamoto T, Nakahara H, Matsugu Y, Ikeda S, et al. Retroperitoneal Bronchogenic Cyst Resected by Single-Incision Laparoscopic Surgery in an Adolescent Female: A Case Report. Asian J Endosc Surg. 2022;15:206\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSullivan SM, Okada S, Kudo M, Ebihara Y. A retroperitoneal bronchogenic cyst with malignant change. Pathol Int. 1999;49:338\u0026ndash;41.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Bronchogenic cyst, Retroperitoneal, Adult, Case report, Diagnosis, Laparoscopic surgery","lastPublishedDoi":"10.21203/rs.3.rs-4263770/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4263770/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAlthough abdominal cysts are frequently observed, retroperitoneal bronchogenic cysts (RBCs) are rare. We encountered a patient with RBC who underwent a series of examinations and surgical resections and was followed up for 5 years.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase presentation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA 31-year-old woman presented to our center with abdominal trauma. Transabdominal ultrasonography (TAUS) inadvertently revealed a cystic lesion in the left upper quadrant, and computed tomography (CT) revealed a large homogeneous fluid-density lesion, which was tentatively diagnosed as a cystic teratoma. Neither ultrasound nor CT showed signs of abdominal organ damage. The patient underwent laparoscopic resection, and the lesion was removed entirely. The histopathology diagnosis was RBC.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRetroperitoneal bronchial cysts are rare and usually clinically asymptomatic. Although rare, retroperitoneal bronchial cysts should be considered in the differential diagnosis of patients with abdominal cystic masses. Imaging examinations, such as ultrasound and CT, are the main ways to detect the disease. Laparoscopyis a feasible and safe treatment for RBCs.\u003c/p\u003e","manuscriptTitle":"Retroperitoneal bronchogenic cyst: a rare case report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-25 16:23:43","doi":"10.21203/rs.3.rs-4263770/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"cf2ea431-2b9a-4223-9fda-9e31ecbcf22f","owner":[],"postedDate":"April 25th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-05-10T09:21:50+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-25 16:23:43","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4263770","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4263770","identity":"rs-4263770","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}