Two concomitant congenital lung malformations mimicking a paravertebral mass

Area of Science:

• Cardiothoracic Surgery
• Pulmonary Medicine
• Congenital Malformations

Background:

• Extralobar pulmonary sequestration (EPS) is a rare congenital lung malformation where lung tissue receives its blood supply from systemic arteries.
• Bronchogenic cysts are congenital lung malformations that arise from abnormal budding of the primitive foregut.
• The co-occurrence of EPS and bronchogenic cysts is exceptionally rare, posing diagnostic challenges.

Observation:

• A 47-year-old woman presented with an asymptomatic, unique malformation.
• The malformation involved an extralobar pulmonary sequestration communicating with a bronchogenic cyst.
• Preoperative imaging, including computed tomography and magnetic resonance imaging, failed to establish a definitive diagnosis.

Findings:

• The definitive diagnosis was made intraoperatively during a left thoracotomy.
• The surgical procedure involved the successful resection of both the sequestrated lobe and the communicating bronchogenic cyst.
• Histopathological examination confirmed the nature of the coexisting malformations.

Implications:

• This case highlights the diagnostic difficulties associated with rare combined pulmonary malformations.
• Early surgical intervention is crucial for managing symptomatic or incidentally discovered pulmonary sequestrations and bronchogenic cysts.
• Reporting such unique cases contributes to a better understanding of congenital lung anomalies and informs clinical management strategies.