Case Report: Bronchogenic cysts with pericardial hypoplasia are directly supplied by the descending aorta.

Bronchogenic cysts (BCs) are a type of congenital mediastinal tumor. This article reports a case that a BC associated with pericardial hypoplasia receives direct arterial supply from the descending aorta, forming a structure resembling pulmonary sequestration. A 17-year-old female was accidentally discovered to have a mediastinal cyst during a routine physical examination. The patient was asymptomatic. Computed tomography (CT) imaging revealed that there was a thick blood vessel on the surface of the cyst, which directly connected to the descending aorta. Following comprehensive preoperative vascular assessment, the cyst was successfully resected intraoperatively by linear cutting stapler, minimizing the risk of significant perioperative hemorrhage. Additionally, partial hypoplasia of the left pericardium was found during the operation, which was suspicious to be related to the BC. Given the limited residual pleural space following cyst removal, pericardial suturing was not performed. This article aims to provide ideas and references for the subtypes and treatment methods of BCs in the future, and emphasizes the importance of preoperative vascular assessment.