The Turkish Journal of Pediatrics
2014 , Vol 56 , Num 2
Rare Localization of an Extralobar Pulmonary Sequestration in a Child as a Diagnostic Challenge: A Case Report and Review of the Literature
Departments of 1Pediatric and Oncological Surgery, 2General Thoracic Surgery, and 3Diagnostic Imaging and Interventional
Radiology, Pomeranian Medical University, Szczecin, Poland. E-mail: k.gizewska@gmail.com
We present a child with a rare finding of an extralobar pulmonary sequestration
localized in the upper mediastinum. Findings of the prenatal screening enabled
early postnatal diagnostic measures that revealed a heterogeneous mass situated
next to the thymus. Based on the localization and inconclusive computed
tomography images, the preoperative prediagnoses included enterogenic cyst,
thymus cyst and teratoma. Intraoperative features of the vascular supply and
structure of the mass drew the surgeons’ suspicion to extralobar pulmonary
sequestration, which was confirmed in the histopathological examination.
The scans were reevaluated after the surgery. Surgical management was
implemented prior to the occurrence of any symptoms, which led to a positive
general outcome.
The presented case should raise the awareness of radiologists, pediatric surgeons and other consultants involved in the diagnostic process of mediastinal lesions in children. The rare localization and lack of visualization of a systemic feeding artery can divert suspicion away from extralobar pulmonary sequestration in the preoperative differential diagnosis.
Keywords : extralobar pulmonary sequestration, mediastinal malformation, prenatal diagnosis, postnatal management.