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      Gastric duplication 20 years after a partial distal gastrectomy: a case report and review of literature

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          Abstract

          Gastric duplications are the least common gastrointestinal duplications, especially in adults. Duplication cyst with an accessory pancreatic lobe is extremely rare and is even more uncommon in the setting of polysplenia. No gastric duplication after partial gastrectomy has been reported. We present a 41-year-old male diagnosed with gastric duplications with an accessory pancreatic lobe and polysplenia. Another characteristic of this case is partial gastrectomy 20 years ago without the discovery of duplication cysts. The gastric duplications, accessory pancreatic lobe and accessory spleen were successfully resected.

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          Most cited references 42

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          Adenocarcinoma arising from a gastric duplication cyst with invasion to the stomach: a case report with literature review.

          This report describes a rare case of adenocarcinoma arising from a gastric duplication cyst, with invasion to the stomach wall, in a 40 year old Japanese man. A cystic lesion was found between the stomach and the spleen. The cyst had a well circumscribed smooth muscle layer, corresponding to the muscularis propria of the stomach and the mucosa of the alimentary tract. A well differentiated adenocarcinoma was found within the duplication cyst, invading its serosa. Well differentiated adenocarcinoma was independently found in the fundus of the stomach; the tumour of the cyst was connected by fibrous tissue. Microscopically, there was neither adenocarcinoma in situ nor precancerous lesions, such as epithelial dysplasia, suggesting that the carcinoma derived from a gastric duplication cyst that invaded the stomach. Duplication cysts should be included in the differential diagnosis of cystic masses of the gastrointestinal tract, and the possibility of malignancy within these cysts should be considered.
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            Duplications of the alimentary tract in infants and children.

            Duplications of the alimentary tract are rare congenital anomalies that could present a diagnostic as well as therapeutic challenge. Twenty-seven patients with duplications of the alimentary tract were treated at Childrens Hospital Los Angeles between 1961 and 1992. Ages ranged from a few days to 5 years (67% younger than 1 year). The most common symptoms were nausea and vomiting, and the most common sign was a palpable abdominal mass. Three patients presented with gastric duplication, which was excised. The majority of the duplications were in the jejunum and ileum. All patients except one had primary resection of the duplication. One patient with a 45-cm tubular jejunal duplication was treated with mucosal stripping of the duplication. Five patients had cecal duplication, three patients presented with melena because of ectopic gastric tissue in the duplication, and two presented with intestinal obstruction. One of the latter patients presented with intussusception with cecal duplication as the leading point. Three patients with colonic duplication presented with abdominal pain and vomiting leading to excision of the duplication. Of the five patients with rectal duplication, three presented with chronic constipation. The other two patients presented elsewhere with perianal swelling, which eventually was drained because of a mistaken diagnosis of perianal abscess. Subsequently, these two patients came to us with persistent perineal fistula. In all our patients, rectal duplications were removed through a sacroperineal incision. The only patient in this series who died was a 6-week-old boy with gastric duplication; his death was attributed to an associated severe cardiac lesion.(ABSTRACT TRUNCATED AT 250 WORDS)
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              High-grade neuroendocrine carcinoma arising in a gastric duplication cyst: a case report with literature review.

              Gastric duplication cysts are rare congenital anomalies that are mostly discovered in children but can remain asymptomatic and undetected into adulthood. Malignant transformation in gastric duplications is extremely rare, with most reported cases being adenocarcinomas. Herein, the authors report the first case of a high-grade neuroendocrine carcinoma arising in a gastric duplication cyst in a 40-year-old Asian male. This case highlights that duplication cysts should be included in the differential diagnosis of cystic masses of the gastrointestinal tract in adult, as well as pediatric, patients and emphasizes the importance of complete surgical resection and meticulous pathologic examination of these congenital anomalies.
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                Author and article information

                Journal
                Ther Clin Risk Manag
                Ther Clin Risk Manag
                TCRM
                tcriskman
                Therapeutics and Clinical Risk Management
                Dove
                1176-6336
                1178-203X
                29 July 2019
                2019
                : 15
                : 943-949
                Affiliations
                [1 ]The Center for Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University , Guangzhou, 510080, People’s Republic of China
                Author notes
                Correspondence: Xin-Hua ZhangThe Center for Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University , #58, Zhongshan 2nd Road, Guangzhou510080, People’s Republic of China Email zhangxh_sysu@ 123456163.com
                Article
                206061
                10.2147/TCRM.S206061
                6677379
                © 2019 Feng et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 5, References: 42, Pages: 7
                Categories
                Case Report

                Medicine

                adult, gastrectomy, accessory pancreatic lobe, polysplenia, gastric duplication

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