Korean J Gastroenterol.  2011 Dec;58(6):346-349. 10.4166/kjg.2011.58.6.346.

Gastric Duplication Cyst Removed by Endoscopic Submucosal Dissection

Affiliations
  • 1Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. doc0224@pusan.ac.kr
  • 2Department of Pathology, Pusan National University School of Medicine, Busan, Korea.

Abstract

Duplication cysts are uncommon congenital malformations that may occur anywhere throughout the alimentary tract. The stomach is an extremely rare site of occurrence. Here, we report a case of gastric duplication cyst initially presenting with a gastric submucosal tumor. A 28-year-old man complained of dyspepsia lasting 1 year and upper endoscopy revealed an ellipsoid submucosal tumor at the greater curvature of the antrum. We intended to use the injection-and-cut technique: however, after saline injection, the lesion was dented and impossible to grasp with a snare. Therefore, we decided to perform endoscopic submucosal dissection and removed the tumor without complication. Histopathology revealed a 0.6x0.6 cm-sized duplication cyst, and there has been no recurrence in 2 years.

Keyword

Stomach; Duplication cyst; Endoscopic resection

MeSH Terms

Adult
Cysts/congenital/*pathology/*surgery
Dissection
Gastric Mucosa/*pathology/*surgery
*Gastroscopy
Humans
Male
Pyloric Antrum/pathology
Stomach Diseases/*pathology/*surgery/ultrasonography

Figure

  • Fig. 1. Endoscopic submucosal dissection of gastric duplication cyst. (A) A submucosal tumor at the greater curvature of the antrum. (B) EUS shows an anechoic homogenous, oval lesion originating from the submucosal layer of the stomach wall; the wall of the cystic lesion is shown as a five-layer structure. (C) After injecting saline with indigo carmine into the submucosa beneath the lesion, the lesion becomes flattened. (D) A complete circumference incision is made using an insulation-tipped knife. (E) The lesion is completely removed. (F) The inner surface of the resected specimen.

  • Fig. 2. Histopathologic features of the resected specimen. (A) Pathologic examination revealed that the submucosal mass was a cystic lesion (H&E, ×20). (B) The cystic space was lined by columnar epithelial mucosa and had its own muscle layer (H&E, ×40). (C) In the cystic wall, ectopic pancreatic tissue was present, consisting of acinar and ductal structures (H&E, ×40). (D) The mucosa consisted of enteric- type columnnar epithelium (H&E, ×40).


Reference

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