Background: This study explores a rare case of bronchogenic cyst manifesting as bronchial asthma in a 3-year-old boy. Bronchogenic cysts, developmental anomalies of the tracheobronchial tree, exhibit diverse presentations depending on their anatomical location. While they are commonly detected incidentally, their manifestation as bronchial asthma is infrequent. The objective is to highlight the importance of recognizing bronchogenic cysts in children with vague respiratory symptoms.

Case detail: The case involves a child experiencing recurrent asthmatic attacks, initially misdiagnosed and conservatively managed. Surgical evaluation identified a left-sided bronchogenic cyst, confirmed by contrast-enhanced computed tomography (CECT) scans. The child underwent successful transthoracic excision, resulting in symptom relief and was thriving during follow-up. The discussion delves into the embryonic development of tracheobronchial trees, the classification of bronchogenic cysts, and the varied clinical presentations. Diagnosis challenges are addressed, emphasizing the significance of a high index of suspicion and advanced imaging techniques.

Conclusion: This report underscores the necessity of considering bronchogenic cysts in pediatric cases with atypical respiratory symptoms and advocates for early identification and surgical intervention to prevent complications. The study contributes valuable insights into the diagnostic and treatment complexities associated with bronchogenic cysts.

Keywords: Bronchogenic cyst, Acute bronchial asthma, Development of respiratory tract, CECT, Transthoracic excisions