Bronchogenic cysts, although relatively rare, represent the most common cystic lesion of the mediastinum. In infants and small children, these cysts can be life threatening when they compress vital structures. In particular, subcarinal cysts can pose life-threatening airway compromise. In infants, the initial presentation may be respiratory distress. More than one half of patients are asymptomatic.

The cysts are usually found using antenatal ultrasonography and routine chest radiography and during evaluations for GI or cardiac symptomatology. Bronchogenic cysts are the result of anomalous development of the ventral foregut; they are usually single but may be multiple and can be filled with fluid or mucus. They have been found all along the tracheoesophageal course, in perihilar or intraparenchymal sites, with a predilection for the area around the carina. Those in the mediastinum frequently attach to, but do not communicate with, the tracheobronchial tree. Bronchogenic cysts have also been described in more remote locations, including the interatrial septum, neck, abdomen, and retroperitoneal space. Less