IntroductionAlimentary tract cystic duplication is a rare congenital anomaly predominantly affecting females, and diagnosed mostly in the early years of life.Case reportWe present here a case of a 51-year-old man presenting with a 2-day history of melena. Gastroscopy showed fresh blood, as well as a mass lesion and cavity at the fundus. Biopsies of the mass edge reported the occurrence of moderately differentiated adenocarcinoma and mild chronic gastritis. Computed tomography imaging showed a 5.1×6.5 cm cystic mass in the gastric greater curvature. The patient received six cycles of epirubicin, capecitabine, and oxaliplatin, followed by uncomplicated total gastrectomy.Literature reviewData from all 11 reports of similar cases were reviewed and pooled. The result shows male predominance and variable symptoms, as well as a wide age range (25–76 years) at presentation. The cysts are commonly located along the greater curvature and are unilocular. Surgery was the treatment in most cases.ConclusionAlimentary tract cystic duplication is rare and may predispose to malignancy. Early diagnosis and prompt surgical intervention is important for the best outcome.

Patient: Female, 55-year-old Final Diagnosis: Esophageal leiomyoma Symptoms: Cough Medication:— Clinical Procedure: — Specialty: Surgery Objective: Rare disease Background: Benign esophageal neoplasms are uncommon, representing less than 10% of esophageal tumors. Esophageal leiomyomas are benign mesenchymal esophageal tumors, typically involving the distal two-thirds of the esophagus. However, upper esophageal leiomyoma is unusual. Signs and symptoms are nonspecific and similar to any esophageal lesion. The role of radiologic imaging in the diagnosis of leiomyoma is vital. Enucleation is the preferred surgical method for treatment of esophageal leiomyoma. In our patient, the presence of a large tumor necessitated esophageal resection and reconstruction. Case Report: A previously healthy 55-year-old woman presented with a chronic productive cough, which did not improve with symptomatic treatment and was not associated with shortness of breath, fever, anorexia, or weight loss. A chest radiograph revealed a superiorly located posterior mediastinal mass, measuring 9.6×4.8×4.6 cm in maximum dimensions. The mass was further evaluated by contrast-enhanced computed tomography, which demonstrated a mass with stippled calcifications, consistent with esophageal leiomyoma. Surgical resection was successfully performed, and the patient had complete resolution of her symptoms. A follow-up visit revealed a postoperative complication of left vocal cord palsy. Speech-language therapy was recommended. Conclusions: Esophageal leiomyoma can present solely with respiratory symptoms without any gastrointestinal involvement and can be misdiagnosed because of atypical symptoms, uncommon location, or atypical imaging features. Recognizing the imaging features and pathologic basis of esophageal leiomyoma is essential for detection, early diagnosis, and management. Endoscopic and radiologic tests are critical to differentiate esophageal leiomyoma from other esophageal lesions and to eliminate the risk of malignancy.