Scapular bronchogenic cysts in children: case report and review of the literature

Abstract

Cutaneous bronchogenic cysts (CBC) are rare solitary lesions which originate from primitive tracheobronchial tree. The periscapular location of these lesions is even a rare condition. The aim of this study is to evaluate this pathology after our case with literature review. An one-year-old girl was brought to our clinics with the complaint of a drainage at the back of her shoulder. In her physical examination, a hyperemic enduration with a sinus and purulent drainage was noted at the left scapular region. Ultrasonography revealed a lesion of 15x11 mm2 in size with a thick wall and a hypoechoic center. The lumen of the cyst was demonstrated with fistulography. Surgical excision of the lesion was performed and pathological examination revealed a cutaneous bronchogenic cyst. CBC have been reported in 64 cases in the literature. They are often found in the lower neck, sternum and shoulders. They arise due to abnormal bronchial budding during the embryological period. Only in 12 of these patients, including our case, the lesion was located in the periscapular area. Its treatment is surgical because of malignant transformation and infection. The recognition of this entity may help the surgeon for early diagnosis.

A congenial cutaneous bronchogenic sinus of the abdominal wall in an infant

“…In our case, the lining epithelium was pseudostratified, columnar epithelium without definite cilia identified. Although ciliated columnar epithelium was not found, the surrounding smooth muscle bundles, mucous glands and a foci of cartilage in the sinus wall supported the diagnosis of a bronchogenic origin [3,7,13]. The absence of cilia may have been due to degeneration [3,13].…”

“…The cutaneous bronchogenic cyst is usually lined by ciliated, pseudostratified, columnar epithelium [3,5]. In our case, the lining epithelium was pseudostratified, columnar epithelium without definite cilia identified.…”

“…Since the first report of subcutaneous bronchogenic cysts by Seybold and Clagett [12] in 1945, about 64 cases have been reported in the English literature [3]. This lesion is more common in males than females [5].…”

“…The treatment of choice, for cutaneous bronchogenic anomalies, is surgical excision due to the potential risk of infection and malignant degeneration [3,15]. Sullivan et al [16] reported a case of adenocarcinoma arising in a retroperitoneal bronchogenic cyst and Endo et al [17] published a report of a bronchioloalveolar carcinoma arising from lung bronchogenic cyst.…”

“…The common locations for cutaneous bronchogenic anomalies are the suprasternal notch, presternal area, neck, and scapula [2]. Uncommon locations are the shoulder and chin [1,3,4]. The abdominal wall region is an extremely rare location for cutaneous bronchogenic cysts, and only one case has been previously reported [5].…”