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Suggest Treatment For Recurring Bronchogenic Cyst
Question: At 23 I had a bronchogenic cyst removed by thoracic surgery. I am now 54 and have 2nd bronchogenic cyst. It is behind my esophogus, 2.3 cm round and 7 cm long. Surgeon wants to aspirated only. Most literature recommends removal. Thoughts?
Brief Answer:
removal is better.
Detailed Answer:
Hello dear, thanks for your question on HCM.
I can understand your situation and problem.
Bronchogenic cyst is benign in nature and if symptomatic then surgical excision is treatment of choice. If asymptomatic then no treatment is required.
Aspiration is also an option but , the chances of recurrence , incomplete removal and infection are high with aspiration.
So my opinion is to go for surgical excision and not for aspiration.
Hope i have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.
removal is better.
Detailed Answer:
Hello dear, thanks for your question on HCM.
I can understand your situation and problem.
Bronchogenic cyst is benign in nature and if symptomatic then surgical excision is treatment of choice. If asymptomatic then no treatment is required.
Aspiration is also an option but , the chances of recurrence , incomplete removal and infection are high with aspiration.
So my opinion is to go for surgical excision and not for aspiration.
Hope i have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
I don't know if it is symptomatic or not. Here is additional information.
I have complained for some time about trouble swallowing but assumed it was scar tissue from the removal of my first cyst 31 years ago. I did mention that drinking something cold does hurt sometimes when it goes down. This took the thoracic surgeon to a path that my symptoms are from esophagus spasms for which I am now scheduled for a barium swallow esophagus probe. When I visited the cardiopulmonary doc he did a breathing test and my exhalation is at 65% of normal, and that after the breathing treatment it came up to the 80s. He put me on Advair, which didn't seem to make a whole lotta difference so I didn't get it refilled (oh, and it costs almost $400 a disc). Now, I don't know if the wheezing/coughing is strictly from the asthma, which is recently exacerbated (my assumption is from the amount of cedar at my new residence, although the wheezing hasn't really improved now that the cedar has died down). The scardy cat in me thinks the cyst is the culprit, but that is likely just me being paranoid.
So, I don't know if my symptoms are from the environment or the cyst. However, most of my research suggests that these cysts should be removed whether there are symptoms or not as symptoms almost always eventually develop. I am presently healthy, except for the wheezing and coughing.
I guess you already said that you would leave it alone if it was asymptomatic. Can you elaborate why?
Thank you for your time.
I have complained for some time about trouble swallowing but assumed it was scar tissue from the removal of my first cyst 31 years ago. I did mention that drinking something cold does hurt sometimes when it goes down. This took the thoracic surgeon to a path that my symptoms are from esophagus spasms for which I am now scheduled for a barium swallow esophagus probe. When I visited the cardiopulmonary doc he did a breathing test and my exhalation is at 65% of normal, and that after the breathing treatment it came up to the 80s. He put me on Advair, which didn't seem to make a whole lotta difference so I didn't get it refilled (oh, and it costs almost $400 a disc). Now, I don't know if the wheezing/coughing is strictly from the asthma, which is recently exacerbated (my assumption is from the amount of cedar at my new residence, although the wheezing hasn't really improved now that the cedar has died down). The scardy cat in me thinks the cyst is the culprit, but that is likely just me being paranoid.
So, I don't know if my symptoms are from the environment or the cyst. However, most of my research suggests that these cysts should be removed whether there are symptoms or not as symptoms almost always eventually develop. I am presently healthy, except for the wheezing and coughing.
I guess you already said that you would leave it alone if it was asymptomatic. Can you elaborate why?
Thank you for your time.
Brief Answer:
you should definitely get done excision.
Detailed Answer:
Hello dear, thanks for your follow up question on HCM.
And extremely sorry for late reply as i was busy with social function.
Thanks for the detailed symptoms.
In my opinion, you should definitely get done barium swallow to rule out esophageal compression due to cyst as a cause for your trouble swallowing.
And your wheezing might be due to subclinical infection in the cyst. Your PFT report is significant of airway obstruction. So in my opinion, you are symptomatic with the cyst and thus surgical excision is needed in your case.
In XXXXXXX surgical expertise in lung cyst is low. And cardiothoracic surgeons are not keen to operate Bronchogenic cyst if it is asymptomatic. Surgery for cyst is itself very complicated and chances of post operative complications are high.
So better not to done anything for asymptomatic cyst.
Hope i have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.
you should definitely get done excision.
Detailed Answer:
Hello dear, thanks for your follow up question on HCM.
And extremely sorry for late reply as i was busy with social function.
Thanks for the detailed symptoms.
In my opinion, you should definitely get done barium swallow to rule out esophageal compression due to cyst as a cause for your trouble swallowing.
And your wheezing might be due to subclinical infection in the cyst. Your PFT report is significant of airway obstruction. So in my opinion, you are symptomatic with the cyst and thus surgical excision is needed in your case.
In XXXXXXX surgical expertise in lung cyst is low. And cardiothoracic surgeons are not keen to operate Bronchogenic cyst if it is asymptomatic. Surgery for cyst is itself very complicated and chances of post operative complications are high.
So better not to done anything for asymptomatic cyst.
Hope i have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thank you so very, very much.
I am scheduled for an EUS by Dr. Inder XXXXXXX (http://www.seton.net/find_a_physician/singh/inder) who is an expert. I feel very good that this procedure will answer questions regarding esophagus compression, infection, and provide further detail for making the surgery decision. All of my doctors except the surgeon are recommending removal. However, the surgeon is the one who ordered this test so it should help to either persuade him or persuade the other doctors.
Thank you for taking your time with me - I truly appreciate it. Your responses were very helpful.
Have a beautiful day.
Sincerely,
XXXXXX
I am scheduled for an EUS by Dr. Inder XXXXXXX (http://www.seton.net/find_a_physician/singh/inder) who is an expert. I feel very good that this procedure will answer questions regarding esophagus compression, infection, and provide further detail for making the surgery decision. All of my doctors except the surgeon are recommending removal. However, the surgeon is the one who ordered this test so it should help to either persuade him or persuade the other doctors.
Thank you for taking your time with me - I truly appreciate it. Your responses were very helpful.
Have a beautiful day.
Sincerely,
XXXXXX
Brief Answer:
thanks for the kind words.
Detailed Answer:
Hello dear, thanks for the kind words.
It always feels great to hear positive response from the patients.
It's encouraging to continue good work.
I am truely obliged with your reply.
Thanks alot.
Hope i have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
Wish you good health. .
Do let me know your progress.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Thanks.
thanks for the kind words.
Detailed Answer:
Hello dear, thanks for the kind words.
It always feels great to hear positive response from the patients.
It's encouraging to continue good work.
I am truely obliged with your reply.
Thanks alot.
Hope i have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
Wish you good health. .
Do let me know your progress.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Thanks.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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