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Extralobar pulmonary sequestration with a cyst: a case report.

ABSTRACT: Extralobar pulmonary sequestration (EPS) is a congenital malformation. In contrast with intralobar sequestration, EPS located outside the normal lung tissue and with a distinct pleural covering. In the current case report, we present a rare case of EPS. To our knowledge, this is the first report of a cyst occurring within the EPS. A 17-year-old male patient presented with chest pain for 1 month. Computed tomography (CT) scan demonstrated a sharply circumscribed mass at the left side of the lower thoracic vertebrae. No aberrant vessel was observed on contrast-enhanced CT. The preoperative diagnosis was a posterior mediastinal tumor or EPS and surgical resection was recommended to the patient. During the operation, an extrapulmonary sequestration lobe was found in the left chest cavity. There was an aberrant artery connecting the sequestration lobe and the descending aorta. A cyst was located in the apex of the sequestration lobe. Surgical resection was performed via thoracoscopy. The postoperative histopathology confirmed an extrapulmonary sequestration combined with a cyst. The patient recovered successfully and was discharged on the sixth day postoperatively. He did not present with recurrent chest pain at the 6-month follow up. EPS should be considered when a posterior mediastinal conical mass is shown on chest CT.

SUBMITTER: Li J

PROVIDER: S-EPMC7475435 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Extralobar pulmonary sequestration with a cyst: a case report.

Li Jian J Jiang Yingmei Y Xiao Jiarong J Liang Guiyou G

Annals of translational medicine 20200801 15

Extralobar pulmonary sequestration (EPS) is a congenital malformation. In contrast with intralobar sequestration, EPS located outside the normal lung tissue and with a distinct pleural covering. In the current case report, we present a rare case of EPS. To our knowledge, this is the first report of a cyst occurring within the EPS. A 17-year-old male patient presented with chest pain for 1 month. Computed tomography (CT) scan demonstrated a sharply circumscribed mass at the left side of the lower ...[more]

PMID: 32953769

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Project description:BACKGROUND:Pulmonary sequestration is a congenital lung disease characterized by nonfunctioning pulmonary tissue that lacks normal communication with the bronchial tree and is supplied by a nonpulmonary systemic artery. Symptomatic bronchopulmonary sequestration is uncommon, seen more frequently in the pediatric population than in adults. It has traditionally been treated with surgical resection; however, a limited but growing number of cases have been treated with angiographic embolization. Given the inherent risks of cardiothoracic surgery, embolization of the anomalous vessel is an enticing alternative treatment. We present a case of a 56-year-old woman with known, symptomatic, intralobar pulmonary sequestration that was successfully treated with coil embolization. CASE PRESENTATION:A 56-year-old Pacific Islander woman with a history of chronic myeloid leukemia was admitted to the hospital with an episode of hemoptysis. Computed tomography of the chest demonstrated left lower lobe intralobar pulmonary sequestration fed by a large tortuous vessel branching off of the descending thoracic aorta. Surgical resection of the sequestration is the current standard treatment strategy of symptomatic intralobar pulmonary sequestration. The cardiothoracic surgeon noted that given the size and location of arterial blood supply, intervention would involve thoracotomy and lobectomy. The interventional radiologist offered embolization of the lesion as an alternative to surgery. Multiple coils, 6-13 mm in size, were used to embolize the sequestration. No considerable flow distal to the coils was noted postembolization. CONCLUSIONS:Intralobar pulmonary sequestration is a rare condition that typically requires surgical management. This case demonstrates the efficacy of coil embolization as an alternative management strategy. To date, limited case reports of adults treated with endovascular embolization exist. Treatment of symptomatic pulmonary sequestration with embolization can be considered as an alternative to surgical resection.

Dataset Information

Extralobar pulmonary sequestration with a cyst: a case report.

Publications

Extralobar pulmonary sequestration with a cyst: a case report.

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