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2010-01-04-16 Answer to the case the week #267 © Faschingbauer www.TheFetus.net


Answer to the case of the week #267

 

April 29, 2010 - May 20, 2010

Christa Faschingbauer, MD.

Germany. 

 

The following images represent a case of the Bronchogenic cyst which was discovered at the 21 weeks of of a twin pregnancy. The diagnosis was obtained after delivery.

Case report

43-year-old G2P1 was referred to our department for a routine second trimester ultrasound scan at 21 weeks. It was a dichorionic, diamniotic twin pregnancy, both fetuses of a female sex. We did not found any abnormalities of the fetus A. There was a mediastinal cyst located under the aortic arch of the fetus B. It remained nearlu unchanged on the next three follow up examinations. The patient delivered two baby girls via cesarean section at 39 weeks. Approximately 2 weeks after delivery, the girl with a mediastinal cyst started to suffer from a dyspnoe.The reason for the breathing difficulties was an atelectasis of the left lung caused by a cyst growth which compressed the left bronchus. The cyst was removed during the surgery. The diagnose of the bronchogenic cyst was confirmed by pathologist. The girl is doing fine since surgery. 

Images 1,2: Sagittal scans of the fetal chest. There is a anechogenic cyst located under the aortic arch, anterior to the thoracic aorta. 

 

Images 3,4:  Image 3 shows a transverse scan of the cyst. Image 4 shows a cyst indicated by arrow and 3 vessel view; aorta (Ao), descending aorta (DA), pulmonary artery (PA), superior vena cava (SVC) and trachea (*).

 

Images 5,6: Image 5 shows series of the transverse scans at the level of the thoracic cyst. Image 6 shows a Doppler imaging of the aortic arch and the cyst located underneath.

 

Images 7,8: Images of the bronchogenic cyst taken during the surgery which performed within couple weeks after delivery.

 

 

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