Young patient with a giant gastric bronchogenic cyst:A case report and review of literature

BACKGROUND Gastric bronchogenic cysts(BCs)are extremely rare cystic masses caused by abnormal development of the respiratory system during the embryonic period.Gastric bronchial cysts are rare lesions that were first reported in 1956;as of 2023,only 33 cases are available in the PubMed online database.BCs usually have no clinical symptoms in the early stage,and imaging findings also lack specificity.Therefore,they are difficult to diagnose before histopathological examination.CASE SUMMARY A 34-year-old woman with respiratory distress presented at our hospital.Endoscopic ultrasound revealed an anechoic mass between the spleen,left kidney and gastric fundus,with hyperechogenic and soft elastography textures and with a size of approximately 6.5 cm×4.0 cm.Furthermore,a computed tomography scan demonstrated high density between the posterior stomach and the spleen and the left kidney,with uniform internal density and a small amount of calcification.The maximum cross section was approximately 10.1 cm×6.1 cm,and the possibility of a cyst was high.Because the imaging findings did not suggest a malignancy and because the patient required complete resection,she underwent laparotomy surgery.Intraoperatively,this cystic lesion was found to be located in the posterior wall of the large curvature of the fundus and was approximately 8 cm×6 cm in size.Finally,the pathologists verified that the cyst in the fundus was a gastric BC.The patient recovered well,her symptoms of chest tightness disappeared,and the abdominal drain was removed on postoperative day 6,after which she was discharged on day 7 for 6 months of follow-up.She had no tumor recurrence or postoperative complications during the follow-up.CONCLUSION This is a valuable report as it describes an extremely rare case of gastric BC.Moreover,this was a very young patient with a large BC in the stomach.

Prognostic value of number of examined lymph nodes in patients with node-negative gastric cancer

AIM:To elucidate the potential impact of examined lymph nodes(eLNs)on long-term survival of nodenegative gastric cancer patients after curative surgery.METHODS:A total of 497 node-negative gastric cancer patients who underwent curative gastrectomy between January 2000 and December 2008 in our center were enrolled in this study.Patients were divided into4 groups according to eLNs through cut-point analysis.Clinicopathological features were compared between≤15 eLNs group and>15 eLNs group and potential prognostic factors were analyzed.The Log-rank test was used to assess statistical differences between the groups.Independent prognostic factors were identifiedusing the Cox proportional hazards regression model.Stratified analysis was performed to investigate the impact of eLNs on patient survival in each stage.Overall survival was also compared among the four groups.Finally,we explored the recurrent sites associated with eLNs.RESULTS:Patients with eLNs>15 had a better survival compared with those with eLNs≤15 for the entire cohort.By the multivariate survival analysis,we found that the depth of invasion and the number of eLNs were the independent predictors of overall survival(OS)of patients with node-negative gastric cancer.According to the cut-point analysis,T2-T4 patients with 11-15 eLNs had a significantly longer mean OS than those with 4-10 eLNs or 1-3 eLNs.Patients with≤15 eLNs were more likely to experience locoregional and peritoneal recurrence than those with>15eLNs.CONCLUSION:Number of eLNs could predict the prognosis of node-negative gastric cancer,and dissection of>15 eLNs is recommended during lymphadenectomy so as to improve the long-term survival.