Veena Bheeman, MBBS, MS, Prem Vignesh Mohan, Vishwanath M Pai, MS, DNB, FRCS, FIAGES, Parimuthukumar Rajappa, MS. Sri Ramachandra Medical College and Research Institute
Introduction: Bronchogenic Cysts are congenital cysts that arise as anomalous budding from the primitive tracheobronchial tree. Incidence of bronchogenic cyst in the wall of the stomach is extremely rare
Case Description: A 23 year old male presented with epigastric pain for one month with no obstructive symptoms. On evaluation with CT, he was found to have a 5.3 x 3.1 cm cystic lesion arising from the posterior aspect of the body of the gastric fundus, partially compressing the stomach. He was provisionally diagnosed to have a stromal tumour of the body of stomach. Owing to persistent pain, the patient was planned for a diagnostic laparoscopy. With the patient in right lateral position, the surgery was then proceeded to Laparoscopic Partial Gastrectomy with excision of the gastric mass using endoscopic staplers. The postoperative course was uneventful. Histopathological Exam showed a serosal cyst with pseudostratified ciliated columnar epithelium with adjacent extensive xanthomatous changes. The final diagnosis was Gastric Bronchogenic Cyst. On follow-up at 4 weeks, patient was asymptomatic.
Discussion: Bronchogenic cysts of stomach are rare developmental malformations of the foregut. They are lined with cuboidal or pseudostratified ciliated epithelium and may or may not be surrounded by elastic fibres, smooth muscle and cartilage. Bronchogenic cysts are common in the hilar and middle mediastinal area, whereas extrathoracic and subdiaphragmatic bronchogenic cysts are rare. Of the 39 previously reported cases of gastric bronchogenic cysts, only 4 have been managed laparoscopically. On radiological imaging, they often appear uncharacteristic and are often diagnosed as GIST. Surgical resection is advised to treat symptoms and prevent malignant transformation.
Conclusion: Gastric bronchogenic cysts are a diagnostic challenge as they often mimic GIST. Symptomatic cases should be dealt with surgical resection.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 85295
Program Number: P136
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster