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      Giant subcutaneous bronchogenic cyst in the intergluteal cleft region of an adult: a case report and literature review

      case-report

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          Abstract

          Background

          Bronchogenic cysts (BCs) are generally detected in the mediastinum, along the tracheobronchial tree, or in the lung parenchyma. Subcutaneous BCs are rare, but, when found, are usually small (< 3 cm) and detected in children.

          Case presentation

          In an unusual adult case, we treated a 52-year-old woman who presented with a mass in the left intergluteal cleft region. Ultrasonography showed a well-circumscribed hypoechoic lesion with posterior enhancement and internal echogenic foci within the mass. Color Doppler images showed no signals. Computed tomography showed the mass as a homogeneous, 6.8- × 6.3- × 5.1-cm soft tissue-attenuation lesion lodged in subcutaneous fatty tissue. Magnetic resonance imaging revealed a cystic lesion of similar dimensions with heterogeneous hyperintensity on both T1- and T2-weighted images. No contrast enhancement, solid components, or restricted diffusion foci were apparent. The cyst was completely excised, and histopathological evaluation indicated it was a BC. The patient’s recovery was uneventful.

          Conclusions

          BCs should be considered in the differential diagnosis of all subcutaneous cystic masses, regardless of their location and size and the patient’s age.

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          Most cited references21

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          Bronchogenic cyst: imaging features with clinical and histopathologic correlation.

          To characterize the imaging features of bronchogenic cysts. The computed tomographic (CT) and/or magnetic resonance (MR) or ultrasonographic images in 68 histopathologically proved cases of bronchogenic cyst in 38 male and 30 female patients, aged newborn to 72 years (mean, 22 years), were retrospectively reviewed. There were 58 mediastinal and 10 extramediastinal cysts. At CT (n = 62), 60 cysts were sharply marginated with smooth (n = 35) or lobulated (n = 25) borders. Twenty-five cysts were of water attenuation, 25 were of soft-tissue attenuation, two were air filled, two had an air-fluid level, and two had dependent milk of calcium. On T1-weighted MR images (n = 23), 18 cysts were hyperintense and five were isointense to cerebrospinal fluid. On T2-weighted MR images (n = 18), 17 cysts were isointense or hyperintense to cerebrospinal fluid. Of the 25 soft-tissue-attenuation lesions at CT, 11 appeared cystic because of internal homogeneity, lack of internal enhancement, mural enhancement, and characteristic location. Fourteen appeared solid based on morphology and attenuation. MR imaging of nine of the latter showed marked hyperintensity on T2-weighted images. CT of bronchogenic cysts typically shows sharply marginated mediastinal masses of soft-tissue or water attenuation. Most appear cystic. A minority appear solid and can be confused with other lesions; MR imaging can be useful for elucidating the cystic nature of these lesions.
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            Overview of epidermoid cyst

            Highlights • The term “sebaceous cyst” has fallen into disuse, the current term is an epidermoid cyst. • Other common synonyms include infundibular cyst, epidermal cyst, epidermal inclusion cyst, and epidermoid inclusion cyst. • These cysts are slow-growing masses that elevate the skin and often have a central punctum. • On radiology, they have round to oval structure, well-circumscribed, avascular mass; restricted diffusion is typical. • Removal may be accomplished by simple excision or incision.
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              Gastric bronchogenic cyst diagnosed by endosonographically guided fine needle aspiration biopsy.

              We report a case of a gastric bronchogenic cyst diagnosed via endosonographically guided fine-needle aspiration (EUS-FNA) biopsy. A 60-year-old woman was referred to our hospital for an endoscopic ultrasound (EUS) examination because of a gastric subepithelial lesion detected by upper gastrointestinal endoscopy. EUS examination revealed a lesion that appeared to originate from the gastric submucosa but seemed to extend beyond the gastric wall. The latter finding raised concerns that the lesion might represent a cystic neoplasm rather than a simple cyst. Subsequently, EUS-FNA was performed to establish a definitive diagnosis and to guide further management. Cytologic evaluation of aspirated material revealed the presence of benign-appearing ciliated columnar epithelial cells within a mucinous background. Based on imaging and EUS-FNA findings, a diagnosis of gastric bronchogenic cyst was made and surgical resection was avoided. (c) 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2008.
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                Author and article information

                Contributors
                719552071@qq.com
                Journal
                BMC Med Imaging
                BMC Med Imaging
                BMC Medical Imaging
                BioMed Central (London )
                1471-2342
                16 July 2022
                16 July 2022
                2022
                : 22
                : 126
                Affiliations
                [1 ]GRID grid.411679.c, ISNI 0000 0004 0605 3373, Department of Orthopedics, First Affiliated Hospital, , Shantou University Medical College, ; Shantou, Guangdong People’s Republic of China
                [2 ]GRID grid.411679.c, ISNI 0000 0004 0605 3373, Department of Radiology, First Affiliated Hospital, , Shantou University Medical College, ; Shantou, 515041 Guangdong People’s Republic of China
                Article
                853
                10.1186/s12880-022-00853-y
                9287924
                35842586
                350c95d1-ce90-470e-845c-ab8d2d4722d6
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 11 June 2021
                : 8 July 2022
                Categories
                Case Report
                Custom metadata
                © The Author(s) 2022

                Radiology & Imaging
                bronchogenic cyst,magnetic resonance imaging,subcutaneous,case report
                Radiology & Imaging
                bronchogenic cyst, magnetic resonance imaging, subcutaneous, case report

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