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Double esophageal duplication cysts, with ectopic gastric mucosa: a case report.

Zhang Z, Jin F, Wu H, Tan S, Tian Z, Cui Y - J Cardiothorac Surg (2013)

Bottom Line: The small (1-cm) esophageal cyst was left untreated based on a "wait-and-see" policy.This finding was consistent with a diagnosis of EDC, with ectopic gastric mucosa.The respiratory tract symptoms resolved immediately after the operation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Thoracic Surgery, The First Hospital of Jilin University, 71 Xinmin Street, Changchun 130021, China. doctorcyb@163.com.

ABSTRACT
Esophageal duplication cyst (EDC) is a congenital malformation of the posterior primitive foregut, which mainly occurs in the thoracic esophagus. Here, we describe a 3-year-old Han Chinese boy afflicted with intermittent fever of acute onset and dry cough. Thoracic computed tomography revealed an 10 cm × 5.4 cm × 5.8 cm oval-shaped, cyst-like tumor located in the extrapleural space, extending along the right paravertebral gutter and compressing the trachea forward. An additional small-sized, oval-shaped cyst was identified in the posterior mediastinum, between the esophagus and the spinal column, at the T1 level. During open thoracotomy, under general anesthesia, an opaque, thick-walled, esophageal cyst was revealed not to be in communication with the esophageal lumen or the trachea. This cyst was subsequently resected in an en bloc manner. The small (1-cm) esophageal cyst was left untreated based on a "wait-and-see" policy. Histological analysis showed that the resected cyst was walled by hyperplastic, fibrous tissues and locally lined with gastric mucosa inherent glands. This finding was consistent with a diagnosis of EDC, with ectopic gastric mucosa. The respiratory tract symptoms resolved immediately after the operation. Computed tomography obtained at the 6-month follow-up showed that no disease, residual or recurrence, was present after the resection of the large-sized cyst, and the small-sized cyst remained unchanged in size.

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Computed tomography scan of esophageal duplication cysts. (A) Transverse and (B) sagittal views of the large-sized cyst; and (C) transverse view of the small-sized cyst (white arrow).
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Figure 1: Computed tomography scan of esophageal duplication cysts. (A) Transverse and (B) sagittal views of the large-sized cyst; and (C) transverse view of the small-sized cyst (white arrow).

Mentions: Three-dimensional CT reconstruction demonstrated that two oval-shaped cystic masses were located in the posterior mediastinum, which displayed well-defined margins and were fluid-filled, yet free of any air-fluid levels. The larger cyst was 10 cm × 5.4 cm × 5.8 cm in size. It was attached to the middle and lower portions of the esophagus in the extrapleural space and extended along the right paravertebral gutter. The cyst compressed the forelying trachea, the right main bronchus, and the right inferior lobe anteriorly (Figure 1A, B). The smaller cyst was located between the posterior wall of the lower cervical esophagus, and the spinal column (level T1), at a size of 1.0 cm × 0.8 cm (Figure 1C). Bilateral bronchopneumonia was evident on chest radiography and CT scan, however, no lymph node enlargements were observed. Contrast-enhanced CT did not reveal any obvious enhancement of either cyst. Diatrizoate meglumine and diatrizoate sodium esophagography excluded the possibility of esophageal stenosis, atresia, or tracheoesophageal fistula (Figure 2). Therefore, the patient was diagnosed with esophageal cyst with complicating bronchopneumonia.


Double esophageal duplication cysts, with ectopic gastric mucosa: a case report.

Zhang Z, Jin F, Wu H, Tan S, Tian Z, Cui Y - J Cardiothorac Surg (2013)

Computed tomography scan of esophageal duplication cysts. (A) Transverse and (B) sagittal views of the large-sized cyst; and (C) transverse view of the small-sized cyst (white arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4222059&req=5

Figure 1: Computed tomography scan of esophageal duplication cysts. (A) Transverse and (B) sagittal views of the large-sized cyst; and (C) transverse view of the small-sized cyst (white arrow).
Mentions: Three-dimensional CT reconstruction demonstrated that two oval-shaped cystic masses were located in the posterior mediastinum, which displayed well-defined margins and were fluid-filled, yet free of any air-fluid levels. The larger cyst was 10 cm × 5.4 cm × 5.8 cm in size. It was attached to the middle and lower portions of the esophagus in the extrapleural space and extended along the right paravertebral gutter. The cyst compressed the forelying trachea, the right main bronchus, and the right inferior lobe anteriorly (Figure 1A, B). The smaller cyst was located between the posterior wall of the lower cervical esophagus, and the spinal column (level T1), at a size of 1.0 cm × 0.8 cm (Figure 1C). Bilateral bronchopneumonia was evident on chest radiography and CT scan, however, no lymph node enlargements were observed. Contrast-enhanced CT did not reveal any obvious enhancement of either cyst. Diatrizoate meglumine and diatrizoate sodium esophagography excluded the possibility of esophageal stenosis, atresia, or tracheoesophageal fistula (Figure 2). Therefore, the patient was diagnosed with esophageal cyst with complicating bronchopneumonia.

Bottom Line: The small (1-cm) esophageal cyst was left untreated based on a "wait-and-see" policy.This finding was consistent with a diagnosis of EDC, with ectopic gastric mucosa.The respiratory tract symptoms resolved immediately after the operation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Thoracic Surgery, The First Hospital of Jilin University, 71 Xinmin Street, Changchun 130021, China. doctorcyb@163.com.

ABSTRACT
Esophageal duplication cyst (EDC) is a congenital malformation of the posterior primitive foregut, which mainly occurs in the thoracic esophagus. Here, we describe a 3-year-old Han Chinese boy afflicted with intermittent fever of acute onset and dry cough. Thoracic computed tomography revealed an 10 cm × 5.4 cm × 5.8 cm oval-shaped, cyst-like tumor located in the extrapleural space, extending along the right paravertebral gutter and compressing the trachea forward. An additional small-sized, oval-shaped cyst was identified in the posterior mediastinum, between the esophagus and the spinal column, at the T1 level. During open thoracotomy, under general anesthesia, an opaque, thick-walled, esophageal cyst was revealed not to be in communication with the esophageal lumen or the trachea. This cyst was subsequently resected in an en bloc manner. The small (1-cm) esophageal cyst was left untreated based on a "wait-and-see" policy. Histological analysis showed that the resected cyst was walled by hyperplastic, fibrous tissues and locally lined with gastric mucosa inherent glands. This finding was consistent with a diagnosis of EDC, with ectopic gastric mucosa. The respiratory tract symptoms resolved immediately after the operation. Computed tomography obtained at the 6-month follow-up showed that no disease, residual or recurrence, was present after the resection of the large-sized cyst, and the small-sized cyst remained unchanged in size.

Show MeSH
Related in: MedlinePlus