Subcutaneous bronchogenic cyst in a child: case report

Bronchogenic cysts are congenital anomalies originating from the primitive tracheobronchial tree in the fetal period. Although the middle mediastinum is the site most commonly affected (second only to the lungs), there have been reports of bronchogenic cysts at unusual sites, such as the retroperitoneum. We report the case of a 4-year-old boy with a cystic mass in the left scapular area since birth. The cyst grew progressively and was accompanied by recurrent episodes of local infection requiring drainage. It was then surgically removed. The histological findings were decisive for the diagnosis: a subcutaneous cyst lined by ciliated columnar epithelium and surrounded by a fibrous wall with smooth muscle tissue, cartilage, and bronchial glands. We also found chronic inflammatory infiltrate, which is consistent with previous episodes of infection. Bronchogenic cysts should be included in the differential diagnosis of cystic tumors of the chest wall and neck, particularly in children. Surgery is the treatment of choice because of the risk of infection, as in this case, and of malignant degeneration.