Gastric foregut cystic developmental malformation: Case series and literature review

Abstract

Foregut cystic developmental malformation (FCDM) is a very rare lesion of the alimentary tract, especially in the stomach. We discuss the concepts of gastric duplication cyst, bronchogenic cysts, and FCDM. Nomenclature has been inconsistent and confusing, but, by some definitions, gastric duplication cysts involve gastric mucosa and submucosal glands, bronchogenic cysts involve respiratory mucosa with underlying cartilage and glands, and FCDM lacks gastric mucosa or underlying glands or cartilage but has pseudostratified ciliated columnar epithelium (PCCE). We searched our departmental case files from the past 15 years and identified 12 cases of FCDM in the alimentary tract. We summarize the features of these 12 cases including a report in detail on a 52-year-old man with a submucosal cyst lined with simple PCCE and irregular and stratified circular muscle layers that merged with gastric smooth muscle bundles near the lesser curvature of the gastric cardia. A literature review of cases with this histology yielded 25 cases. We propose the term gastric-FCDM for such cases. Our own series of 12 cases confirms that preoperative recognition of the entity is infrequent and problematic. The rarity of this developmental disorder, as well as a lack of understanding of its embryologic origins, may contribute to missing the diagnosis. Not appreciating the diagnosis preoperatively can lead to an inappropriate surgical approach. In contrast, presurgical recognition of the entity will contribute to a good outcome and reduced risk of complications.

An Unusual Cause of a Recurrent Liver Abscess in a Young Boy

“…Gastric duplication cysts accounts for 9% of all duplication cysts and are usually found in the greater curvature. 1 The majority of the cysts, in contrast with the presented boy, are noncommunicating with the gastric lumen.…”

Large bronchogenic cyst of stomach: A case report

“…Bronchogenic cyst is the term, traditionally, used to describe a cyst lined by PCCE with the presence of cartilage or glandular tissue in the cyst wall. However, some recent studies have grouped intra mural gastric cyst with a lining of PCCE into a single entity as gastric foregut cystic developmental malformation which includes foregut cyst, bronchogenic cyst and duplication lined by PCCE [7], [8]. On extensive Medline/Pubmed search, we found only 38 reported cases of classical gastric bronchogenic cyst till date.…”

Endoscopic Esophageal Submucosal Tunnel Dissection for Cystic Lesions Originating from the Muscularis Propria of the Gastric Cardia

“…The first case was misdiagnosed as a stromal tumor in the initial diagnosis. Gastric foregut, on the other hand, is also likely to be misdiagnosed as stromal tumor [ 3 ]. Endoscopic ultrasonography (EUS) and CT are the most important differential diagnosis methods.…”

“…The gastric cardia is the most common site of gastric submucosal tumors [ 1 ], most of which are leiomyomas and stromal tumors. Cystic lesions originating from the muscularis propria of the gastric cardia (CLMPGC) are considered a rare benign disease [ 2 , 3 ]. Most cardiac cystic lesions are gastric foregut cysts [ 3 , 4 ] and esophageal cysts; congenital anomalies may cause the former, and the latter is mostly induced by trauma and surgery [ 5 ].…”