A 26-year-old male was referred to general surgery after being accidentally diagnosed after imaging by the Digestive Service of a mass in the left diaphragmatic crura due to admission due to an IBD sprout.
Her personal history included bronchial asthma, Schonleich-Henoch purpura in childhood, ileal Crohn's disease diagnosed in 2004 and a smoker.
Physical examination revealed right flank abdominal tenderness in relation to IBD. No masses or enlargement were found.
Computed tomography (CT) identified terminal ileum with thickened walls and signs of vascular proliferation in relation to Crohn's disease, in addition to a 7.6 x 4.4 cm lesion with well-defined borders and low density of the left diaphragm tabra.
CT-guided percutaneous puncture was performed and the pathological result was reported as abundant necrotic material with numerous polymorphonucleated leukocytes and frequent histiocytes negative for malignant cells.
We performed a midline laparotomy and access to the left infradiaphragmatic retroperitoneal cavity with removal of a mass that was closely adhered to the adrenal gland, upper pole of the kidney and left diaphragm with direct exeresis of part of it.
Postoperative recovery was uneventful and the patient was discharged on postoperative day 7.
The definitive pathological report was an irregular bronchogenic cyst of elastic consistency of 8 x 4 x 4 cm cavitated and purulent aspect.
The microscopic description was reported of cystic formation with lumens covered by simple columnar epithelium pseudostratified and tapered cells.
Few goblet cells.
Smooth muscle bundles are isolated.
No evidence of malignancy.
