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Bronchogenic cyst in a patient with difficult asthma
Soheil Ben Razavi1, Mohammad Hassan Bemanian, Shokooh Taghipoor
1Department of Surgery, Division of Pediatric Surgery, Shaheed Sadoughi Hospital, Yazd, Iran.
Iranian Journal of Allergy, Asthma, and Immunology
|June 16, 2010
Summary
A rare bronchogenic cyst caused difficult-to-treat asthma in a young girl. This congenital anomaly, a foregut malformation, presented as a mediastinal mass compressing the trachea, mimicking severe asthma symptoms.
Area of Science:
- Pediatric Pulmonology
- Thoracic Surgery
- Developmental Pediatrics
Background:
- Difficult-to-treat asthma necessitates exploring differential diagnoses beyond typical triggers.
- Mediastinal masses are uncommon but critical considerations in pediatric airway obstruction.
- Bronchogenic cysts, congenital foregut anomalies, often present incidentally in the mediastinum.
Observation:
- A 4-year-old girl with persistent allergic asthma since 8 months of age experienced severe exacerbations requiring Pediatric Intensive Care Unit admission.
- Imaging revealed a 4x3 cm posterior mediastinal mass causing significant tracheal narrowing.
- Surgical exploration and pathological examination confirmed the mass as a bronchogenic cyst compressing the thoracic trachea.
Findings:
- The bronchogenic cyst was identified as the underlying cause of the patient's refractory asthma symptoms.
- This case highlights a rare etiology for obstructive airway disease in children.
- Successful surgical resection of the cyst resolved the airway compression and asthma symptoms.
Implications:
- Bronchogenic cysts should be considered in the differential diagnosis of pediatric asthma, particularly when management is ineffective.
- Early detection and surgical intervention are crucial for managing airway compression caused by mediastinal anomalies.
- This case underscores the importance of comprehensive diagnostic evaluation for persistent respiratory symptoms in children.
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