Bronchogenic cysts are embryonic abnormalities that may be difficult to distinguish from enteric duplication cysts, according to specialists at the University Center for Fetal Medicine. Symptoms caused by these cysts, which can include compression of the bronchi and distal airway obstruction, are directly related to their size and location. Even when no symptoms are present prenatally, stridor, respiratory distress, bronchial obstruction and infection are possible after birth.
Bronchogenic cysts may be detected in the prenatal period by routine screening, ultrasonography or as the result of obstetrical indications. Once the concern for a thoracic mass is raised, referral to a tertiary care center is indicated. The prenatal evaluation should include a high-resolution ultrasound and fetal MRI to define the anatomy and aid in the correct diagnosis.
Once the diagnosis of a bronchogenic cyst is made, the family is counseled regarding the etiology, pre- and postnatal management and likely outcomes. Prenatal care consists of serial ultrasounds to assess maternal and fetal well-being. Delivery should take place at a tertiary care center with NICU and pediatric surgeon availability. The newborn will be carefully monitored at birth in regards to respiratory status. A chest X-ray, MRI and echocardiogram will be obtained as soon as the baby is stable.
All bronchogenic cysts require surgical resection because of the potential for infection, obstruction and malignancy, but the timing of the resection will vary due to the presentation of the newborn and the symptoms that are present. Surgery may take place as soon as the symptomatic newborn has been fully evaluated or at approximately one month of age if the newborn is asymptomatic. Recovery time and length of hospital stay depend on the infant’s response to treatment.