Bronchogenic Cysts of the Mediastinum in Infancy

Of 10 infants with mediastinal bronchogenic cysts seven were in severe or moderate respiratory distress at admission. In none was the precise diagnosis of bronchogenic cyst made before operation. In four, including all three fatal ones, the presence of a mediastinal mass was not even recognized. Seven of the eight infants operated upon survived and were alive and well up to 20 years later. Two infants died without surgery. Variable clinical and radiographic findings of bronchogenic cysts of the mediastinum may obscure diagnosis and delay treatment. Chest films may show severe hyperaeration, areas of collapse, atelectasis of an entire lung, or a mediastinal mass. Complete obstruction of a bronchus in utero can lead to retention of fetal fluid within the lung, which may be mistaken for a pulmonary tumor.