Intraspinal bronchogenic cyst: Series of case reports and literature review

Abstract

Purpose: Spinal bronchogenic cysts (SBCs) are rare congenital lesions. The clinical and imaging characteristics and treatment of SBCs are not well known. We studied three cases of SBCs retrospectively, which were registered in our department and analyzed eight case reports which were all published in English, focusing on providing a deeper knowledge of SBCs. Methods: Three patients with SBCs registered in our department were retrospectively reviewed. Eight reported SBCs cases published from 1992 to 2015 were enrolled in our study. Imaging diagnosis was confirmed by computed tomography (CT), MRI, and computed tomography angiography (CTA). All of our patients and reviewed cases had undergone surgical resection and the final diagnosis was made by pathological examination. Results: Five lesions were located at the cervical spinal canal. Most patients presented with pain in the limbs and back, which might be related to compression of the spinal cord and the reduced blood supply of the anterior spinal artery. The signal intensity on MRI was correlated with cystic fluid traits to a large extent. Seven lesions were partially removed because of the adhesions to the nearby spinal cord. All reported cases had no recurrence in the later follow-up. Conclusions: SBCs can occur anywhere in the spinal canal, but they are more likely to present at the cervical canal and might be present along with some developmental malformations of the spine. We emphasize the role of CT and MRI findings in the disease diagnosis. It is recommended that the lesion should be removed as completely as possible.

Upper Cervical Bronchogenic Cyst: A Rare Condition at a Rare Location

“…Hence, SBC has not been reported above C3 vertebral level. [ 8 10 ] Thus, the current case is the first reported instance of upper cervical SBC. Not surprisingly, in this case, no vertebral anomalies such as hemivertebra, spina bifida, or fusion anomalies of the vertebra were noted in view of the rare upper cervical spine location of the cyst.…”

“…SBC is an extremely rare condition and only few cases of SBCs have been published in literature. [ 8 ]…”

“…[ 11 ] Some papers have also described the presence of fat in the cyst wall which would again favor the second theory of ectodermal origin where differentiation into fat, respiratory epithelium is possible. [ 8 ] Cysts located at the level of lumbar spine are more likely associated with spinal deformities such as spina bifida and tethering of the cord unlike the ones located at the cervical and thoracic level. [ 12 ] Therefore, a common embryological anomaly causing both cord tethering and lumbar SBC has also been proposed.…”

“…who noted that none of the patients had a secondary change in the SBC at the time of the presentation. [ 8 ]…”

“…In contrast to a recent paper, where lipomatous tissue was noted in the cyst wall in some cases, no such fat was noted in our case. [ 8 ] Surgical excision is the treatment modality of choice; however, complete excision is not always possible due to adherence of the cyst wall to the cord. Hence, only in 4/11 of the published cases, the cyst could be completely resected.…”