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      Foregut Duplication Cyst of the Stomach: A Case Report and Review of the Literature

      case-report

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          Abstract

          Duplication cyst of the stomach is a rare congenital malformation, typically diagnosed in the first year of life. In most adult cases the cyst remains asymptomatic, but patients may present with abdominal symptoms including epigastric discomfort or pain. We present a case of a 65-year-old male with an asymptomatic gastric tumor diagnosed incidentally during initial workup of his esophageal adenocarcinoma. Computed tomography revealed a low density soft tissue tumor near the gastroesophageal junction. Endoscopic ultrasonography demonstrated a cystic lesion as a hypoechoic round mass with well-defined borders. Following complete laparoscopic resection, microscopic review revealed a cyst lined with respiratory pseudostratified ciliated columnar epithelium and layers of smooth muscle with an outermost thin fibrous capsule consistent with a foregut duplication cyst.

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          Surgical management of alimentary tract duplications.

          Tyler J O’Neill, H Bishop, A Gheissari … (1989)
          Alimentary tract duplications are unusual anomalies that may require surgical intervention in the neonate, infant, and occasionally in the older child. The clinical presentation of patients with alimentary tract duplications includes bleeding, abdominal pain, intussusception, and respiratory distress, or it may be an incidental finding on either abdominal examination or chest x-ray. A review of 96 patients with 101 duplications seen over the last 37 years is reported herein. Twenty-one duplications were confined to the thorax; three were thoracoabdominal, and 77 were abdominal. Seventy-four patients presented as infants less than 2 years of age, and 22 patients were older. Ectopic gastric mucosa was found in 21 duplications, and pancreatic tissue was found in five. Seventy-five duplications were cystic and 26 were tubular. Ultrasonography, computed tomography (CT), and myelography are helpful diagnostic tools. Ninety-four of the 96 patients underwent surgical management for their duplications. One duplication was found at necropsy, and one patient was asymptomatic and did not undergo operation. A single death occurred in a 2-day-old infant who had intrauterine volvulus and meconium peritonitis. Management was based on the age and condition of the patient, the location of the lesion, whether it was cystic or tubular and communicating with the true intestinal lumen, and whether it involved one or more anatomic locations. Generally, total excision was preferred, but staged approaches were sometimes necessary.
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            Adenocarcinoma arising from a gastric duplication cyst with invasion to the stomach: a case report with literature review.

            H Nakayama-Imaohji, T Ichikawa, W Yasui … (2004)
            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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              Management of alimentary tract duplication in children.

              Simon M. Stringer, R R ABEL, B. E. Kiely … (1994)
              Duplication of the alimentary tract is rare but potentially dangerous. Five of 72 children with alimentary tract duplication treated between 1973 and 1992 died from postoperative complications; a further ten required more than one operation. Ileal duplications were the commonest, occurring in 16 patients (22 per cent). Thoracoabdominal duplications were the most complicated and responsible for much of the overall morbidity and mortality. Surgical complications were related to the size and location of the duplication, communication with the gastrointestinal tract or vertebral canal, presence of heterotopic gastric mucosa and involvement of mesenteric vessels. Complete excision of the duplication should be possible in most cases.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Case Rep Pathol
                Journal ID (iso-abbrev): Case Rep Pathol
                Journal ID (publisher-id): CRIPA
                Title: Case Reports in Pathology
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2090-6781
                ISSN (Electronic): 2090-679X
                Publication date (Print): 2016
                Publication date (Electronic): 21 February 2016
                Volume: 2016
                Electronic Location Identifier: 7318256
                Affiliations
                1Department of Pathology and Laboratory Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
                2Department of Radiology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
                Author notes

                Academic Editor: Akira Mima

                Article
                DOI: 10.1155/2016/7318256
                PMC ID: 4779517
                PubMed ID: 26998376
                SO-VID: 7482da0f-0f81-4d7e-b131-00d515f9a007
                Copyright © Copyright © 2016 Y. Tjendra et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 6 October 2015
                Date accepted : 17 January 2016
                Categories
                Subject: Case Report

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