HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ciccone, A. M. Articles by Rendina, E. A. Search for Related Content PubMed Articles by Ciccone, A. M. Articles by Rendina, E. A.

Eur J Cardiothorac Surg 2006;29:629
© 2006 Elsevier Science NL

Case report

Editorial comment

Division of Thoracic Surgery, University of Rome "La Sapienza", Sant’ Andrea Hospital, Via Grottarossa 1035-1039, 00189 Rome, Italy

^_* Corresponding author. Tel.: +39 06 33775003; fax: +39 06 33775773. (Email: amciccone{at}hotmail.com; erinoangelo.rendina{at}tin.it).

Bronchogenic cysts are the most common cystic lesions in the middle mediastinum in adults. Most mediastinal bronchogenic cysts arise near the tracheal carina in relationship to the major airways and rarely communicate with the tracheobronchial tree. Surgical resection is the therapy of choice, even though bronchogenic cysts usually present as an asymptomatic finding and can be monitored by serial follow-up imaging studies. Recent series show that bronchogenic cysts should always be removed as, even if patients do not initially present with symptoms, most eventually become symptomatic with long-term follow-up and complications can develop if these cysts are left unattended. Therefore, the progressive fluid collection and the consequent increase in size which will produce respiratory symptoms, the development of infection and the occurrence of malignant degeneration within the cysts, justify early interventions at the time of diagnosis. In fact, the onset of symptoms makes the surgical procedure more difficult for both the surgeon and the patient.

The procedure for removing a simple bronchogenic cyst is relatively easy with minimal morbidity for the patient; furthermore, with the advent of video-assisted thoracoscopic techniques, the period of disability and hospitalization is also shorter.

Complete excision of a bronchogenic cyst is the goal and the recurrence is extremely rare. The most important point for preventing recurrence of the cyst is the complete resection of the mucosal lining.

No secreting mucosal surface should be left behind and surgery is the most appropriate treatment to accomplish this goal.

Transthoracic and transbronchial needle aspirations have been proved useful procedures as well, both diagnostically and therapeutically, yet have never achieved universal acceptance. In fact, aspiration of the content of the cyst does not allow the lining removal.

Dr Galluccio and Dr Lucantoni [1] have provided an interesting case report on endoscopic ultrasound capability in evaluating and treating a recurrent mediastinal bronchogenic cyst when associated with a standardized but underestimated procedure like FNA. This paper is somehow provocative; in fact, even though the aggressiveness of some interventional bronchoscopists is not always justified and accepted, in this case has been rewarded with excellent results.

Several studies show that ultrasound has been of some value in the evaluation of mediastinal lesions, particularly for the purpose of needle guidance, and a wider appliance of this procedure would be desirable in the future.

	References

Top References

 

1. Galluccio G, Lucantoni G. Mediastinal bronchogenic cyst's recurrence treated with EBUS-FNA with a long-term follow-up. Eur J Cardiothorac Surg 2006;29:627-629.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ciccone, A. M. Articles by Rendina, E. A. Search for Related Content PubMed Articles by Ciccone, A. M. Articles by Rendina, E. A.