Retroperitoneal Bronchogenic Cysts: A Case Series

BACKGROUND Bronchogenic cysts are a rare congenital malformation of primitive foregut development, predominantly located in the thorax. However, they can also be found in various atypical locations, including the retroperitoneal space. Retroperitoneal bronchogenic cysts are exceedingly rare. The diagnosis of retroperitoneal bronchogenic cysts presents considerable difficulty owing to their rarity and the absence of distinctive clinical and imaging characteristics. CASE REPORT This study reports 6 surgically confirmed cases of retroperitoneal bronchogenic cysts at our institution. One patient presented with abdominal pain, while the others were asymptomatic and discovered incidentally through imaging. All the cysts were found adhered to the left diaphragm on cross-sectional imaging. The cysts exhibited relatively high attenuation on unenhanced computed tomography (CT) and showed no or mild enhancement on contrast-enhanced CT. Only 1 case was accurately diagnosed with a retroperitoneal bronchogenic cyst prior to surgery; the others were confirmed through postoperative histopathology. All patients underwent resections of the lesions through the retroperitoneal approach, and their recovery was uneventful. No evidence of recurrence was found during the follow-up period. CONCLUSIONS Retroperitoneal bronchogenic cysts should be considered in the differential diagnosis of a retroperitoneal mass, particularly if found on the left side and adhered to the diaphragm. The rarity of this disease presents the biggest preoperative diagnostic challenges. When masses suspected of retroperitoneal bronchogenic cysts appear solid on CT, magnetic resonance imaging (MRI) may be a valuable adjunct to reveal the cystic nature of these lesions. Minimally invasive surgical resection remains the gold standard for treatment. Prognosis is typically excellent after complete surgical resection.