Abdominal ectopic bronchogenic cysts: a retrospective single-institution case series and literature review

Abdominal ectopic bronchogenic cysts (EBCs) are rare congenital malformations that are frequently misdiagnosed preoperatively due to their nonspecific and often asymptomatic presentation. This study aimed to elucidate the clinical characteristics, diagnostic challenges, and optimal management of abdominal EBCs by integrating data from a sizable single-institutional case series with a comprehensive literature review.

We conducted a retrospective analysis of 12 patients with pathologically confirmed abdominal bronchogenic cysts who were treated at our institution from January 2015 to January 2024. Data on demographic characteristics, clinical presentation, imaging features, surgical management, and pathological findings were collected. A comprehensive review of the pertinent literature was also performed to identify published case reports and series. Data are presented using descriptive statistics, including medians and proportions.

The cohort comprised 12 patients (7 male, 5 female) with a median age of 46 years. Eight patients (66.7%) were symptomatic. The most common symptom was epigastric pain, presenting in 7 patients (58.3%). Eleven cysts (91.7%) were located in the upper abdominal retroperitoneum. Eleven patients (91.7%) were misdiagnosed preoperatively. Laparoscopic complete resection was achieved in 9 patients (75%), while 3 patients (25%) underwent open surgery. The diagnosis was histologically confirmed in all cases by the identification of ciliated pseudostratified columnar epithelium. One patient (8.3%) experienced recurrence following initial fenestration and required reoperation.

Abdominal bronchogenic cysts present a considerable diagnostic challenge, resulting in a high preoperative misdiagnosis rate. It should be considered in the differential diagnosis of an abdominal cystic neoplasm. Laparoscopic complete resection represents a safe and effective therapeutic approach, yielding favorable outcomes. Complete surgical excision is paramount to prevent recurrence. Surgical intervention is, therefore, recommended to achieve both diagnostic confirmation and definitive therapy.