Abstract

Background: Gastric bronchogenic cyst (GBC) is an exceedingly rare congenital anomaly characterized by non-specific imaging features and significant overlap with other gastric cystic lesions or subepithelial tumors. Accurate identification of this entity is essential for establishing appropriate management strategies. Case Presentation: We report the case of a 64-year-old female patient with an incidentally detected gastric subepithelial mass. Contrast-enhanced chest and abdominal computed tomography revealed a mass with fluid attenuation abutting the gastric fundus, featuring mural calcifications and no enhancement. The initial presumptive diagnosis was a xanthomatous lesion. The patient underwent laparoscopic complete excision of the lesion. Gross examination revealed a cyst containing turbid yellow mucoid fluid. Histopathologic examination showed a cyst wall lined by ciliated pseudostratified columnar epithelium, with underlying mixed glands, smooth muscle bundles, and hyaline cartilage. No evidence of invasion into adjacent structures or regional lymph node metastasis was observed. The definitive diagnosis was confirmed as a bronchogenic cyst. Conclusion: Gastric bronchogenic cyst represents a diagnostic “pitfall” for both clinicians and radiologists. This report highlights the preoperative diagnostic challenges of GBC and underscores the critical role of complete excision and comprehensive histopathologic assessment in securing a definitive diagnosis, guiding appropriate management, and optimizing patient outcomes.