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Mediastinal gastroenteric cyst in a neonate containing respiratory-type epithelium and pancreatic tissue
Eleftherios Anagnostou1, Vasiliki Soubasi, Eleni Agakidou
1Department of Pathology, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece. eleanagn@otenet.gr
Insights
This study reports a rare congenital mediastinal gastroenteric cyst in an infant with unusual respiratory and pancreatic tissues. Surgical removal led to a full recovery, highlighting a unique case of foregut duplication.
Area of Science:
- Pediatric Surgery
- Congenital Malformations
- Histopathology
Background:
- Mediastinal gastroenteric cysts are rare congenital foregut duplications primarily affecting neonates and infants.
- Typical histology includes a smooth muscle wall and gastric mucosa.
Observation:
- A 2-day-old infant presented with severe respiratory distress due to a posterior mediastinal cystic mass.
- The cyst was multilocular and associated with T3-T4 hemivertebrae.
Findings:
- Histopathological analysis revealed a gastroenteric cyst with areas of respiratory-type epithelium and pancreatic tissue.
- This combination of epithelial lining and pancreatic tissue within a single mediastinal foregut cyst is highly unusual and rarely reported.
Implications:
- This case expands the understanding of the variable histopathology in mediastinal foregut duplication cysts.
- Early surgical intervention is crucial for managing respiratory compromise caused by these lesions.
Abstract:
Mediastinal gastroenteric cyst is an uncommon congenital malformation and a distinct histopathological entity within the family of foregut duplication cysts. This lesion is mainly encountered in neonates and infants. Histologically, it is characterized by double-layered smooth muscle wall and gastric lining mucosa. We report on a case of a 2-day-old girl, with a posterior mediastinal cystic mass associated with T3-T4 hemivertebrae, presenting with severe respiratory distress. The cyst was multilocular, surgically removed, and histopathologic analysis revealed that it was of gastroenteric type. However, in numerous areas of the lesion, respiratory-type epithelium was observed, as well as pancreatic tissue. After removal of the lesion the patient made an uneventful recovery and shows no signs of long-term pulmonary sequelae. We failed to demonstrate in the available literature the presence of this variable epithelial lining within a single mediastinal foregut cyst. In addition, pancreatic tissue within an intrathoracic enteric cyst has been reported only twice.
