Subcarinal Bronchogenic Cyst Causing Chest Pain in an 18-year-old Female

Abstract A bronchogenic cyst is a congenital lesion resulting from abnormal development of the ventral foregut and tracheobronchial tree during embryogenesis, which is usually detected incidentally in most cases. This case reports a young age with atypical chest pain. Her initial workup, including physical examination, ECG was unremarkable, which contributed to the initial diagnosis of musculoskeletal pain, leading to a delay in discovering the cyst. Two weeks later, recurrent pain and progression of the symptoms prompted further imaging evaluation, including chest X-ray, magnetic resonance imaging, and computed tomography angiography, which were performed, revealing a 4 cm × 4 cm subcarinal mass, compressing the superior vena cava, the right pulmonary artery, and the right main bronchus. Esophagogastroduodenoscopy and bronchoscopy were performed, showing no evidence of invasion. Afterward, the patient underwent video-assisted thoracic surgery (VATS) for bronchogenic cyst resection and was discharged with no surgical complications. Histopathological findings confirmed the diagnosis of a bronchogenic cyst, with no evidence of dysplasia or malignancy. The postoperative recovery was uneventful, with complete resolution of her symptoms and no evidence of recurrence. This emphasizes the need for detailed investigation in young patients with atypical chest pain, even when initial findings are benign.