Gastric duplication cyst with ectopic pancreas in a teenager successfully resected by endoscopic submucosal dissection

Abstract

Background Gastric duplication cyst associated with ectopic pancreas is rare and we aimed to alert clinician to this congenital anomaly. Case presentation A 15-year-old girl presented with intermittent vomiting. Gastroscopy showed a submucosal tumor with an approximate diameter of 40 mm in the anterior wall of the gastric antrum. The lesion had a central umbilication and was diagnosed preliminarily as gastric ectopic pancreas with pseudocyst formation on the basis of its appearance. However, computed tomographic scan showed a thick-walled cystic lesion with an enhanced outline of the cystic wall in the antrum of stomach, suggestive of duplication cyst. Serum amylase was normal. Endoscopic ultrasonography revealed a solid-cystic lesion; the solid portion were inhomogeneously mixed with echoes, and had indistinct border to muscularis propria; the cystic portion had echogenic internal mucosal layer and distinct border to muscularis propria. Endoscopic submucosal dissection (ESD) was suggested for the patient to relieve symptoms and diagnose the lesion definitely. The operation procedure was uneventful and the solid-cystic lesion was resected completely. Histopathologic examination revealed that the solid portion was ectopic pancreas, and the cystic portion was gastric duplication cyst. After resection, the patient discharged successfully and neither symptoms nor tumors recurred during the 9 months follow-up period. Conclusions This is the first case of a solid-cystic lesion with central umbilication in the stomach diagnosed as gastric duplication cyst associated with ectopic pancreas. ESD could be an optional treatment to provide a definitive diagnosis.

A Multi-Centric Comparative Study Between Endoscopy-Assisted Laparoscopic Surgery (EALS) vs Laparoscopic Surgery for the Treatment of Gastric Duplication Cysts in Children

“…The cause of GDC may be related to the formation of a duplicate stomach when a group of cells detach from the main body when the foregut differentiates into the stomach in the embryonic stage. 8 Most GDCs are found in prenatal examinations and physical examinations of newborns and children, and some are found in adulthood. 9 Their clinical manifestations are different.…”

Acute peritonitis caused by the acute pancreatitis of an ectopic pancreas in a jejunal duplication, in an adult with intestinal malrotation: a case report

“…Table 1 summarizes 11 cases of ectopic pancreas in intestinal duplication, including the present case [ 9 – 18 ]. The median age of the eight male patients and three female patients was 35 (15–69) years.…”