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Published on: February 28, 2025
Gastric bronchogenic cyst histologically diagnosed after laparoscopic excision: report of a case
Tomohiro Kurokawa1, Masayoshi Yamamoto, Takanori Ueda
11 Department of Surgery, Tsukuba Medical Center Hospital, Tsukuba City, Japan.
Insights
A rare gastric submucosal tumor was diagnosed as a bronchogenic cyst, originating from the primitive foregut. This finding highlights the need to consider these rare gastric cysts in differential diagnoses of abdominal cystic diseases.
Area of Science:
- Gastroenterology
- Pathology
- Radiology
Background:
- Gastric submucosal tumors are uncommon, with diverse origins.
- Bronchogenic cysts typically occur in the mediastinum or thoracic cavity.
- Gastrointestinal manifestations of bronchogenic cysts are exceedingly rare.
Observation:
- A 71-year-old man presented with a 3-cm gastric cardia mass.
- Imaging revealed a widely attached mass with specific signal intensities on MRI (homogenous high on T2W1, isointense on T1W1, no high intensity on diffusion-weighted imaging).
- Initial suspicion was a gastric submucosal tumor.
Findings:
- Laparoscopic tumor resection was performed.
- Histopathology confirmed the mass as a bronchogenic cyst, an anomaly of respiratory primordium originating in the foregut.
- This represents an extremely rare occurrence of a bronchogenic cyst within the gastric wall.
Implications:
- Bronchogenic cysts should be included in the differential diagnosis of abdominal unilocular cystic diseases.
- This case expands the known locations for bronchogenic cyst presentation.
- Accurate preoperative diagnosis can be challenging but is crucial for appropriate management.
Abstract:
Abdominal computed tomography of a 71-year-old man revealed a 3-cm mass in gastric cardia. Although the mass was widely attached to the gastric wall, no clear contrast enhancement was observed. Abdominal magnetic resonance imaging revealed the mass to have homogenous high intensity on T2W1 images and isointensity on T1W1 images. On diffusion-weighted imaging, no high intensity was observed. However, the mass had a smooth surface and was widely attached to the gastric wall, consistent with computed tomography findings. A gastric submucosal tumor was suspected. Laparoscopic tumor resection was performed. Histopathologic diagnosis of the mass was a bronchogenic cyst derived from the respiratory primordium originating in the foregut of the primitive intestine. Such cysts are mostly found in the mediastinum or thoracic cavity; their occurrence on the gastric wall is extremely rare. Despite this, we think that bronchogenic cysts should be considered in the differential diagnosis of abdominal unilocular cystic diseases.
