A case report- retroperitoneal bronchogenic cyst in relation to the hindgut

Introduction: Bronchogenic cysts are developmental anomalies which occur as an abnormal budding of the primitive foregut or tracheobronchial tree. Bronchogenic cysts arise most often in the mediastinum. They can occur in many atypical locations. A retroperitoneal location is exceptionally unusual.

Presentation of case: We present the case of a 46-year-old male with complaints of dyspeptic symptoms, who, on routine evaluation was found to have a mass in the Left iliac fossa. The patient's past medical and surgical history is unremarkable and had no history of trauma. The patient's clinical examination was unremarkable except for mild tenderness in the Left iliac fossa. Routine Pre-operative Blood investigations were within normal limits. Computed Tomography showed 4 × 3.4 cm lesion on the anterior surface of the left psoas muscle just abutting the left ureter. A colonoscopy done revealed normal study. The tumour was excised in-toto through a retroperitoneal approach.

Discussion: Bronchogenic cysts are rare primitive foregut derived developmental aberrations in early embryonic life, typically occurring in the mediastinum. They arise from an abnormal budding of the tracheobronchial anlage of the primitive foregut between the 3rd and 7th weeks of development. Retroperitoneal bronchogenic cysts occur almost equally in men and women. CT and MRI are found to be ideal imaging modalities Surgical resection of these lesions is recommended. Laparoscopic surgery is preferred. Only one case of a retroperitoneal bronchogenic cyst associated with the development of adenocarcinoma has been reported.

Conclusion: The differential can be kept in mind when incidentally detected cysts are found during diagnostic imaging for other symptoms.