Cervical bronchogenic cysts mimic metastatic lymph nodes during thyroid cancer surgery.
OBJECTIVE
Although congenital bronchogenic cysts in the cervical region, especially in the thyroid or perithyroidal area, are rare, distinguishing them from other cervical cystic lesions (e.g., thyroglossal duct and branchial cleft cysts) and metastatic cervical lymph nodes is difficult preoperatively. Additionally, cystic degeneration of metastatic lymph nodes is common in patients with thyroid cancer. We investigated the clinical characteristics and proper treatment for individuals with cervical bronchogenic cysts.


METHODS
Of the 18,900 patients treated for thyroid cancer, 18 patients with pathologically confirmed bronchogenic cysts were retrospectively reviewed. Bilateral total thyroidectomy or less than total thyroidectomy with central compartment node dissection, including cystic mass excision was done and cystic mass was confirmed by postoperative pathologic examination.


RESULTS
All cervical bronchogenic cysts were asymptomatic. Their mean size was 1.2 cm (range, 0.3 to 3 cm). Of these 18 patients, 15 did not have any abnormal radiological findings, except for lymphadenopathy during preoperative evaluations. Most bronchogenic cysts were detected around the thyroid and paratracheal areas. On preoperative imaging and intraoperatively, most were indistinguishable from metastatic cervical lymph nodes or other cystic lesions.


CONCLUSIONS
Although cervical bronchogenic cysts are rare and benign, they should be distinguished from other cystic cervical masses, especially metastatic cervical lymph nodes associated with thyroid cancer. Possible cervical bronchogenic cysts found during thyroid cancer evaluation or surgery should be surgically excised.
Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Hak Hoon
HH
Jun
Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Seok Mo
SM
Kim
Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Yong Sang
YS
Lee
Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Soon Won
SW
Hong
Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Hang-Seok
HS
Chang
Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Cheong Soo
CS
Park
Bronchogenic cyst; Thyroid neoplasms