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Thoracoscopic resection of foregut duplication cyst in a neonate
Saurabh Tiwari1, Paras Kothari1, Abhaya Gupta1
1Department of Pediatric Surgery, LTMMC and GH, Mumbai, Maharashtra, India.
Insights
Foregut duplication cysts, though rare, can occur in newborns. Early thoracoscopic surgery proved safe and effective for treating a neonatal foregut duplication cyst, representing the earliest intervention reported.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Congenital Anomalies
Background:
- Foregut duplication cysts are congenital anomalies with varying presentations.
- While often benign, ectopic gastric mucosa poses a risk of malignant transformation.
- Bronchopulmonary involvement is more common in female patients.
Observation:
- A female neonate presented with an antenatally diagnosed right-sided thoracic mass.
- Imaging revealed a 4.1 cm × 3.7 cm × 8 cm foregut duplication cyst in the posterior mediastinum.
- The cyst was successfully resected via thoracoscopy on day 14 of life.
Findings:
- Histopathology confirmed the diagnosis of foregut duplication cyst.
- Postoperative recovery was uneventful.
- This case represents the earliest reported thoracoscopic intervention for neonatal foregut duplication.
Implications:
- Neonatal thoracoscopy is a safe and effective surgical approach for foregut duplication cysts.
- Early intervention may improve outcomes for neonates with thoracic masses.
- Further research into optimal timing and techniques for managing these anomalies is warranted.
Abstract:
Foregut duplication is more common in girls, particularly if there is bronchopulmonary involvement. The incidence of oesophageal duplication cyst is estimated to be one in 8200 live births with male prevalence. Most duplications are benign, but the presence of ectopic gastric mucosa and the potential for malignant degeneration remain a concern. A newborn female, antenatally diagnosed with right-sided thoracic mass, was diagnosed with a foregut duplication cyst of size 4.1 cm × 3.7 cm × 8 cm in the posterior mediastinum. Thoracoscopic resection was done on day of life 14. The postoperative recovery was uneventful and histopathology confirmed the diagnosis. A literature search revealed only a few cases of an early thoracoscopic intervention, and ours is the earliest reported. Thoracoscopy in the neonatal period is safe and effective.
