Posterior Mediastinal Bronchogenic Cyst in an Adult: A Case Report and Review of Diagnostic Challenges

Abstract

Bronchogenic cysts are rare congenital lesions of the mediastinum originating from abnormal development of the tracheobronchialtree. In adults, posterior mediastinal involvement is uncommon and may present diagnostic challenges due to nonspecific clinicalsymptoms and radiologic similarities to other mediastinal masses. A 51-year-old man presented with a one-month history ofpersistent chronic cough unresponsive to antibiotics. Chest radiography revealed a left paracardiac mass. Contrast-enhancedthoracic computed tomography demonstrated a large, well-circumscribed cystic lesion measuring 9.3 × 9 × 14 cm in the lefthemithorax with compressive atelectasis of the left lower lobe. Flexible bronchoscopy showed extrinsic compression with narrowingof the left B8 and B9 bronchi without endobronchial lesions. Complete excision was achieved via video-assisted thoracoscopicsurgery, and histopathology confirmed a bronchogenic cyst. Posterior mediastinal bronchogenic cysts in adults are rare anddiagnostically challenging. Minimally invasive surgical resection provides definitive diagnosis and excellent clinical outcomes.