Analysis of the Diagnosis and Radical Resection Treatment for Cervical Bronchogenic Cysts

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Background: Cervical bronchogenic cysts are rare congenital developmental abnormalities. Most patients are asymptomatic in the initial stage and lack typical imaging features; however, as the cyst grows, it can compress surrounding tissues and organs, leading to secondary complications such as acute hemorrhage, infection, and perforation. At the time of this writing, surgical resection is the most effective method for treating these tumors, but the displacement and seeding of exfoliated cells can lead to recurrence and metastasis of the tumors. How to achieve radical resection has become the most concerning issue for surgeons. Case presentation: A 55-year-old female presented to our clinic on December 19, 2023, with a painless neck mass that had been present for 3 years. She experienced no discomfort affecting her daily life, and the results from the laboratory test were normal. Ultrasound and CT examinations showed a cystic tumor was observed at the suprasternal notch, measuring approximately 30 mm in diameter. The thyroid capsule appeared intact and had not been compromised. A midline anterior cervical incision was employed to enable direct visualization and precise excision of the tumor. Throughout the surgical procedure, extraordinary care was taken to meticulously dissect and liberate the adjacent tissues, ensuring an optimal safety margin for the complete removal of the lesion while minimizing the risk of detached cell implantation. Postoperative pathologic examination confirmed the tumor as a cervical bronchogenic cyst. Follow-up to date shows no evident signs of recurrence. Conclusions: This case serves as a valuable reference for the diagnosis and treatment of cervical bronchogenic cysts. Although most cysts remain asymptomatic in their early stages, we still advocate for early surgical intervention to preemptively address potential severe complications and mitigate greater risks or challenges that may arise later. Grounded in principles from developmental biology, achieving complete resection of the neoplasm is essential for maximizing therapeutic efficacy. Furthermore, from our perspective, the surgical field and operating space in open surgery under direct vision are more conducive to achieving effective radical resection while maximizing the protection of normal tissues.

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