Neonatal respiratory distress syndrome revealing a cervical bronchogenic cyst: a case report

BMC Pediatrics

Gilles Cambonie³  Michel Mondain¹  Nicolas Leboucq²  Renaud Mesnage³  Maliha Badr³  Catherine Blanchet¹  Penelope Thaller³ 

[1] Department of Pediatric Otorhinolaryngology, Hôpital Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, Montpellier Cedex 5, 34295, France;Department of Neuroradiology, CHU Montpellier, Montpellier, F-34000, France;Department of Neonatology and Pediatric Intensive Care Unit, Hôpital Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, Montpellier Cedex 5, 34295, France

关键词: Tracheostomy;    Neonatal respiratory distress syndrome;    Cervical bronchogenic cyst;   

Others  :  1217903
DOI  :  10.1186/s12887-015-0363-2

 received in 2014-10-17, accepted in 2015-04-13,  发布年份 2015

【 摘 要 】

Background

Bronchogenic cyst is a congenital malformation, rarely located in the cervical region and almost never involved in a neonate with acute respiratory distress in the delivery room.

Case presentation

A female newborn with respiratory distress syndrome caused by a large left cervical mass. Intubation was difficult due to tracheal deviation. Magnetic resonance imaging confirmed a left cervical cyst displacing the trachea and esophagus laterally. Surgical excision was performed via a cervical approach on the 5th day, and pathological examination revealed a bronchogenic cyst. The patient's course was complicated by left vocal cord paralysis and necrotic lesions in the glottic and subglottic regions; she required a tracheostomy on the 13th day. Inflammatory stenosis in the subglottic region required balloon dilation once, 20 days later. Proximal esophageal stenosis induced transient upper airway obstruction with salivary stasis. Decannulation was performed at 2 months and the patient was discharged 10 days later.

Conclusion

A bronchogenic cyst can exceptionally obstruct the airways in the neonatal period. Surgical excision is necessary, but postoperative complications may occur if the cyst is in close contact with the trachea and esophagus, including necrotic and stenotic lesions of the upper aerodigestive tract. In those situations, tracheostomy may be necessary for mechanical ventilation weaning and the initiation of oral feeding.

【 授权许可】

   
2015 Thaller et al.

【 图 表 】

Fig. 1.

Fig. 2.

【 参考文献 】

• [1]Mehta RP, Faquin WC, Cunningham MJ. Cervical bronchogenic cysts: a consideration in the differential diagnosis of pediatric cervical cystic masses. Int J Pediatr Otorhinolaryngol. 2004; 68:563-8.
• [2]Teissier N, Elmaleh-Bergès M, Ferkdadji L, François M, Van den Abbeele T. Cervical bronchogenic cysts: usual and unusual clinical presentations. Arch Otolaryngol Head Neck Surg. 2008; 134:1165-9.
• [3]Goswamy J, de Kruijf S, Humphrey G, Rothera MP, Bruce IA. Bronchogenic cysts as a cause of infantile stridor: case report and literature review. J Laryngol Otol. 2011; 125:1094-7.
• [4]Bocciolini C, Dall'olio D, Cunsolo E, Latini G, Gradoni P, Laudadio P. Cervical bronchogenic cyst: asymptomatic neck mass in an adult male. Acta Otolaryngol. 2006; 126:553-6.
• [5]Marks C, Marks P. The embryologic basis of tracheobroncho-pulmonary maldevelopment. Int Surg. 1987; 72:109-14.
• [6]Joshi R, Cobb AR, Wilson P, Bailey BM. Lingual cyst lined by respiratory and gastric epithelium in a neonate. Br J Oral Maxillofac Surg. 2013; 51:173-5.
• [7]Gaikwad P, Muthusami JC, Raj JP, Rajinikanth J, John GM. Subcutaneous bronchogenic cyst. Otolaryngol Head Neck Surg. 2006; 135:951-2.
• [8]El Youssef R, Fleseriu M, Sheppard BC. Adrenal and pancreatic presentation of subdiaphragmatic retroperitoneal bronchogenic cysts. Arch Surg. 2010; 145:302-4.
• [9]Levine D, Jennings R, Barnewolt C, Mehta T, Wilson J, Wong G. Progressive fetal bronchial obstruction caused by a bronchogenic cyst diagnosed using prenatal MR imaging. AJR Am J Roentgenol. 2001; 176:49-52.
• [10]Bernasconi A, Yoo SJ, Golding F, Langer JC, Jaeggi ET. Etiology and outcome of prenatally detected paracardial cystic lesions: a case series and review of the literature. Ultrasound Obstet Gynecol. 2007; 29:388-94.
• [11]Kaji T, Takamatsu H, Noguchi H, Tahara H, Fukushige T, Mukai M, Ibara S, Maruyama H, Yoshiyama K. Cervico-mediastinal bronchogenic cyst occurring in the prenatal period: report of a case. Surg Today. 2000; 30:1016-8.
• [12]Cavel O, Kokta V, Reveret M, L’Allier M, Froehlich P, Lapointe A. Subglottic bronchogenic cyst presenting as neonatal asphyxia. Case report and literature review. Int J Pediatr Otorhinolaryngol Extra. 2013; 8:92-96.
• [13]Liechty KW. Ex-utero intrapartum therapy. Semin Fetal Neonatal Med. 2010; 15:34-9.
• [14]Laje P, Peranteau WH, Hedrick HL, Flake AW, Johnson MP, Moldenhauer JS, Adzick NS. Ex utero intrapartum treatment (EXIT) in the management of cervical lymphatic malformation. J Pediatr Surg. 2015; 50:311-4.
• [15]Kieran SM, Robson CD, Nosé V, Rahbar R. Foregut duplication cysts in the head and neck: presentation, diagnosis, and management. Arch Otolaryngol Head Neck Surg. 2010; 136:778-82.
• [16]Sumiyoshi K, Shimizu S, Enjoji M, Iwashita A, Kawakami K. Bronchogenic cyst in the abdomen. Virchows Arch A Pathol Anat Histopathol. 1985; 408:93-8.14.
• [17]Ashizawa K, Okimoto T, Shirafuji T, Kusano H, Ayabe H, Hayashi K. Anterior mediastinal bronchogenic cyst: demonstration of complicating malignancy by CT and MRI. Br J Radiol. 2001; 74:959-61.