Foregut duplication cyst of the stomach with pseudostratified columnar ciliated epithelium

Abstract

Duplication cyst of the stomach with pseudostratified columnar ciliated epithelium is extremely rare. A 72-year-old Japanese woman visited Oomoto Hospital for examination of the stomach. Gastroendoscopy indicated a slightly depressed gastric cancer in the anterior wall of the middle third of the stomach. Adenocarcinoma was confirmed on endoscopic biopsy. Preoperative CT indicated a subserosal cystic lesion 2 cm in diameter on the lesser curvature of the stomach. The cystic lesion was resected through distal gastrectomy and systematic lymph node dissection. Histopathology showed that the cyst did not communicate with the gastric lumen, had pseudostratified columnar ciliated epithelium with circular muscle layers, and did not have gastric epithelium or cartilaginous tissue. The gastric cancer consisted of moderately differentiated adenocarcinoma with submucosal invasion and lymph node metastasis. Consequently, the present patient was diagnosed as having foregut duplication cyst of the stomach.

Foregut duplication cysts: A report of two cases with emphasis on embryogenesis

“…Histologically, they are usually lined with a typical gastric mucosa [15] . As in the present two cases, a ciliated pseudostratified epithelium has been reported [3][4][5][6][7][8][9][10][11][12] .…”

“…Foregut duplications may or may not communicate with the gastrointestinal tract, and are usually diagnosed at a young age [2] . There have been relatively few case reports describing this entity [3][4][5][6][7][8][9][10][11][12] Adenocarcinoma has been reported in four cases of gastric duplication cyst, but not in cysts that have a ciliated epithelium [13][14][15][16] . Controversy exists concerning the embryological origin of these anomalies [11,17,18] .…”

Gastric Duplication Cyst Removed by Endoscopic Submucosal Dissection

“…5,6 Small and asymptomatic duplication cysts are usually recommended observation and follow up. In case of need for removal of a gastric duplication cyst, conventional treatment is surgical resection and recently minimal invasive surgery and laparoscopic treatment of gastric duplication cyst were applied.…”

“…In case of need for removal of a gastric duplication cyst, conventional treatment is surgical resection and recently minimal invasive surgery and laparoscopic treatment of gastric duplication cyst were applied. 4,5 In this case, we intended to use the injectionand-cut technique with upper endoscopy: however, after saline injection, the lesion was dented and impossible to grasp with a snare. Therefore, we performed ESD.…”

“…3 Traditionally, gastric duplication cysts are surgically removed by minimal invasive laparoscopic techniques and there have been a few reports on endoscopic treatment for gastric duplication cyst. 4,5 We report a case of gastric duplication cyst that was removed with endoscopic submucosal dissection (ESD).…”