腹膜后支气管源性囊肿一例并文献复习

Retroperitoneal bronchogenic cyst:report of a case and literature review

目的探讨腹膜后支气管源性囊肿(RBC)的诊治并文献复习。方法回顾性分析2019年1月5日中山大学附属第三医院粤东医院收治的1例RBC患者临床资料。患者女,28岁,因“左下腹隐痛不适两个月余伴加重1周”就诊,临床表现为左下腹隐痛,无其他特征性临床表现。患者签署知情同意书,符合医学伦理学规定。总结患者的临床表现、辅助检查及治疗方法,并进行文献复习。结果患者CEA、AFP、CA125、CA19-9均正常。超声检查示肝右叶后方、右肾上腺区囊性占位,无明显血供。增强CT示右肾上极、右肾上腺区及右肝后上间隙肿物,密度不高且质地不均匀,未见明显强化。于2019年1月9日在气管插管全身麻醉下行腹腔镜RBC切除术。术后病理学检查确诊为RBC。患者术后恢复良好,随访至投稿日期无复发。结论RBC极为罕见,术前无特异性检查手段,影像学检查可提供有限的临床数据,手术切除为有效的治疗手段,大多预后良好。

Objective To investigate the diagnosis and treatment of retroperitoneal bronchogenic cyst(RBC)and conduct literature review.Methods Clinical data of 1 RBC patient admitted to Yuedong Hospital of the Third Affiliated Hospital of Sun Yat-sen University on January 5,2019 were retrospectively analyzed.A 28-year-old female patient was admitted to our hospital due to"dull pain in the left lower abdomen for over 2 months and aggravated for 1 week".Clinical manifestation was dull pain in the left lower abdomen without other specific clinical features.The informed consent of this patient was obtained and the local ethical committee approval was received.Clinical manifestations,auxiliary examinations and treatment methods were summarized,and literature review was conducted.Results The CEA,AFP,CA125 and CA19-9 of the patient were normal.Ultrasound examination showed cystic space-occupying in the rear right liver lobe and right adrenal region,without evident blood supply.Contrast-enhanced CT scan demonstrated a mass with low density,uneven texture and no significant enhancement in the upper pole of right kidney,right adrenal region and right retrohepatic space.On January 9,2019,laparoscopic RBC resection with tracheal intubation was performed under general anesthesia.Postoperative pathological examination confirmed the diagnosis of RBC.The patient recovered well after the surgery,and did not recur before submission date.Conclusions RBC is extremely rare in clinical practice.There is no specific examination tools for the diagnosis before surgery.Imaging examination can provide limited clinical data.Surgical resection is an efficacious treatment,and most patients can obtain favorable clinical prognosis.