ACQUIRED BRONCHOMALACIA DUE TO A MEDIASTINAL BRONCHOGENIC CYST MANAGED WITH BRONCHIAL STENTING AND CYST EXCISION: A CASE REPORT

Abstract

Background: Bronchogenic cysts are uncommon congenital foregut malformations that may remain occult until adulthood, but enlarging mediastinal lesions can compress central airways and rarely produce acquired bronchomalacia. Case presentation: A 53-year-old woman presented with six months of cough with white mucopurulent sputum, exertional dyspnea, chest tightness, and weight loss. Radiography showed a left mediastinal opacity; contrast-enhanced computed tomography demonstrated a 5.0 x 5.3 x 4.4 cm multiloculated left para-esophageal middle-mediastinal cyst compressing the left main bronchus and adjacent vascular structures. Bronchoscopy confirmed severe left main bronchial narrowing. After surgical excision, persistent dynamic collapse indicated compression-related acquired bronchomalacia. Rigid bronchoscopy with silicone bronchial stent deployment restored airway patency. Histopathology confirmed a bronchogenic cyst. Conclusion: Bronchogenic cyst-related bronchomalacia is rare. Patients with major airway compression require preoperative and postoperative bronchoscopic assessment; cyst excision combined with silicone stenting can provide effective airway stabilization.