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An unusual left upper quadrant mass: a bronchopulmonary foregut malformation
R L McDermott1, D O Kavanagh, W Bartosik
1Department of Colorectal Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Case Reports in Surgery
|March 28, 2013
Summary
A rare developmental anomaly, bronchopulmonary foregut malformation with pulmonary sequestration, presented as a large abdominal mass. Surgical resection was successful, highlighting the importance of considering this condition in the differential diagnosis.
Area of Science:
- Medicine
- Developmental Biology
- Surgical Pathology
Background:
- Bronchopulmonary foregut malformations (BPFM) are rare congenital anomalies involving the foregut and lung.
- These malformations typically occur in the thoracic cavity but can present intrathoracically or extrathoracically, including subdiaphragmatically.
- Pulmonary sequestration, a component of BPFM, involves lung tissue that does not communicate with the bronchial tree.
Purpose of the Study:
- To report a unique case of a subdiaphragmatic bronchopulmonary foregut malformation with pulmonary sequestration.
- To provide a comprehensive review of the embryology, clinical presentation, and management strategies for these rare entities.
- To enhance awareness among clinicians regarding this unusual cause of abdominal masses.
Main Methods:
- Case presentation of a patient with epigastric discomfort and a left upper quadrant mass.
- Preoperative evaluation including imaging and diagnostic workup.
- Surgical resection of the mass with en bloc excision of a portion of the left hemidiaphragm.
- Histopathological analysis of the resected specimen.
Main Results:
- A large (9 × 10 × 11 cm) subdiaphragmatic mass was successfully resected.
- Histopathology confirmed a bronchopulmonary foregut malformation with pulmonary sequestration.
- The patient experienced an uneventful postoperative recovery.
Conclusions:
- Bronchopulmonary foregut malformations can occur below the diaphragm, presenting as abdominal masses.
- Early diagnosis and surgical intervention are crucial for favorable outcomes.
- This case underscores the importance of considering rare developmental anomalies in the differential diagnosis of abdominal masses.
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