Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2020; 8(8): 1525-1531
Published online Apr 26, 2020. doi: 10.12998/wjcc.v8.i8.1525
Bronchogenic cyst of the stomach: A case report
Wen-Ting He, Jing-Yu Deng, Han Liang, Jian-Yu Xiao, Fu-Liang Cao
Wen-Ting He, Jing-Yu Deng, Han Liang, Department of Gastroenterology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, and Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
Jian-Yu Xiao, Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, and Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
Fu-Liang Cao, Department of Endoscopy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, and Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
Author contributions: He WT was the major contributor in writing the manuscript and editing the pictures; Liang H advised the manuscript; Deng JY was involved in drafting, writing, and editing the manuscript, and reviewed the manuscript as corresponding author; Xiao JY and Cao FL contributed to providing results obtained by radiology and endoscopy; all authors read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81572372; National Key Research and Development Program "Major Chronic Non-infectious Disease Research", No. 2016YFC1303200; and National Key Research and Development Program "Precision Medicine Research", No. 2017YFC0908304.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jing-Yu Deng, MD, PhD, Chief Doctor, Professor, Department of Gastroenterology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, and Tianjin’s Clinical Research Center for Cancer, West Lake Road, Hexi District, Tianjin 300060, China. dengery@126.com
Received: December 29, 2019
Peer-review started: December 29, 2019
First decision: January 19, 2020
Revised: March 27, 2020
Accepted: April 10, 2020
Article in press: April 10, 2020
Published online: April 26, 2020
Processing time: 116 Days and 17.7 Hours
Abstract
BACKGROUND

Gastric bronchogenic cysts (BCs) are extremely rare cystic masses caused by abnormal development of the respiratory system during the embryonic period. Gastric bronchial cysts are rare lesions first reported in 1956; as of 2019, only 37 cases are available in the MEDLINE/PubMed online databases. BCs usually have no clinical symptoms in the early stage, and their imaging findings also lack specificity. Therefore, they are difficult to diagnose before histopathological examination.

CASE SUMMARY

A 55-year-old woman presented at our hospital with intermittent epigastric pain. She had a slightly high level of serum carbohydrate antigen 72-4 (CA 72-4). Endoscopic ultrasound found that a cystic mass originated from the submucosa of the posterior gastric wall near the cardia, indicating a diagnosis of cystic hygroma of the stomach. Furthermore, a computed tomography scan demonstrated a quasi-circular cystic mass closely related to the lesser curvature of the gastric fundus with a low density. Because the imaging examinations did not suggest a malignancy and the patient required complete resection, she underwent laparoscopic surgery. As an intraoperative finding, this cystic lesion was located in the posterior wall of the fundus and contained some yellow viscous liquid. Finally, the pathologists verified that the cyst in the fundus was a gastric BC. The patient recovered well with normal CA 72-4 levels, and her course was uneventful at 10 mo.

CONCLUSION

This is a valuable report as it describes an extremely rare case of gastric BC. Moreover, this is the first case of BC to present with elevated CA 72-4 levels.

Keywords: Bronchogenic cyst; Stomach; Submucosal lesion; Endoscopic ultrasound-guided fine needle aspiration; Endosonography; Case report

Core tip: Gastric bronchogenic cysts (BCs) are extremely rare and present as non-characteristic cysts on preoperative examinations. We report a rare case of gastric BC with elevated carbohydrate antigen 72-4 which is symptomatic and even not be considered for a correct diagnosis before surgery. The diagnosis of gastric BC was confirmed by the final pathological results after laparoscopic resection. We emphasize that BCs should be included in the differential diagnosis of cysts occurring in the stomach detected by imaging. And we recommend trying to acquire indication whether the mass invades the stomach wall through enhanced computed tomography to give doctors confidence in diagnosis. Endoscopic ultrasound-guided fine needle aspiration may provide the definite diagnosis of gastric BCs and even allows for conservative treatment, but much research will be still needed to confirm that.