Endoscopic Removal of a Cervical Esophageal Duplication Cyst.

A 6-month-old female presented for 2 months of noisy breathing. Flexible laryngoscopy showed limited bilateral vocal fold abduction. Computed tomography revealed a non-enhancing 3.6 × 2.3 × 3.5 cystic prevertebral mass spanning C2-T. Using an endoscopic approach, the overlying mucosa was incised, and the cyst was freed and fully excised from the surrounding mucosa with blunt microlaryngeal instruments without complication. Three months postoperatively she had no respiratory issues and was eating well. Flexible laryngoscopy revealed bilateral vocal fold mobility. We propose that endoscopic removal of a cervical esophageal duplication cyst in selected cases is an alternative to open excision. Laryngoscope, 130:2053-2055, 2020.

An esophageal cyst containing heterotopic gastric glands

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An esophageal cyst containing heterotopic gastric glands.

A 71-year-old man came to our hospital for endoscopic treatment of a suspicious early gastric carcinoma. A 0.6×0.4 cm protrusive esophageal lesion with smooth surface was found accidentally, located at about 20 cm from the incisors. The lesion was successfully resected by endoscopic mucosal resection, which was esophageal cyst containing heterotopic gastric glands.

A Case Report of Esophageal Bronchogenic Cyst and Review of the Literature With an Emphasis on Endoscopic Ultrasonography Appearance.

Esophageal bronchogenic cysts are extremely rare. Here we report a more rare type of both presence of intra- and paraesophageal bronchogenic cyst that was safely removed via surgical resection. A 31-year-old male patient with space-occupying lesions in the mediastinum suddenly presented with persistent chest pain for 2 days and then transferred to dysphagia >1 week. Preoperative diagnosis is difficult. Endoscopic ultrasonography (EUS) showed a hypoechoic cystic-solid mass arising from the muscularis propria and local hyperechoic area in the deeper portion of cyst, concomitant with a heterogeneous center and tube-like structure lesion in mediastinum. Turbid coffee color paste contents were aspirated inside the tumor under endoscopic ultrasonography guided-fine needle aspiration (EUS-FNA). A subsequent surgery was performed and histologic finding was diagnostic of esophageal bronchogenic cyst. Immunohistochemical staining confirmed the cyst was positive for carbohydrate antigen 199 (CA199) and carbohydrate antigen 125 (CA125). At a follow-up visit 3 months later, the patient had a regular diet and no complaint. This study is to summarize the clinical manifestations and EUS features of esophageal bronchogenic cyst by retrospectively reviewing the literature and simultaneously to provide guide for the correct examination scheme. The appearance of esophageal bronchogenic cyst can be great variation; EUS seems to be a valuable option for diagnosis and surveillance.

Endoultrasonography (EUS) examination of the esophagus in the diagnosis of esophageal duplication: a case report and a review of a literature.

Esophageal duplication cysts are a rare medical entity. In most cases they are located at the level of the distal esophagus. Although our case is not unique, we want to focus on it as a reflection on diagnostic methods. The aim of this article is to show through the report on a case of esophageal duplication treated by us, followed by a review of similar cases in the literature, the utility of EUS in the diagnosis of upper-diaphragmatic and not communicating esophageal duplication. We report a case of a 43 year-old woman. She came to our attention for heartburn and retrosternal sense of space. The patient underwent an endoultrasonography (EUS) examination of the esophagus. The framework put EUS diagnosis of cystic formation of the esophagus (esophageal duplication cysts likely). We demonstrate that only EUS has a correlation with the determination of the pre-operative diagnosis with a statistical significance (p <0.001). In the diagnosis of esophageal not communicating duplication cysts EUS is the most specific diagnostic exam.

Cervico-mediastinal Esophageal Duplication Cyst - Case Presentation.

INTRODUCTION: esophageal cysts can be divided into 2 categories: simple epithelial-lined cysts and esophageal duplication, which is an embryologic duplication of a portion of the muscle and submucosa of the esophagus without epithelial duplication. CASE PRESENTATION: 48 year-old male, with no relevant history, was transferred in our department with vomiting, dysphagia, anorexia, and weight loss. The CT scan highlights a tumor mass, well defined, with maximum size of 6.5 cm, developed in the left upper mediastinum and lower left cervical region. We decided to perform surgery in order to remove the mass completely. The approach was through a cervical incision, allowing access to the upper mediastinum, as well as for the anterior cervical region. DISCUSSION: Complete surgical excision is recommended for all foregut cyst malformations. Considering the localization of the esophageal cyst in our patient, we decided cervico-sternotomy will be the best approach, giving a wide exposure of the mediastinum and of the lower cervical region if necessary. The lesion was carefully dissected from the surrounding structures and completely removed. CONCLUSION: All esophageal cysts should be evaluated and, eventually, resected. Most patients with esophageal cysts eventually become symptomatic; therefore, cysts should be resected when they are diagnosed.

Voluminous oesophageal bronchogenic cyst treated with thoracoscopic approach.

AIM: Bronchogenic cysts are congenital lesions deriving from the primitive foregut, and are usually located in close relation to tracheobronchial tree or oesophagus. We report a case of an oesophageal bronchogenic cyst appearing at preoperative examinations as a benign fibromuscular tumour (leiomyoma). CASE REPORT: A 62 years old male patient in good general conditions, was admitted to our Institution because of moderate dysphagia and upper post-prandial abdominal pain. Conventional imaging, endoscopy and echo endoscopy detected a parietal oesophageal wall mass looking like a solid formation, determining extrinsic compression and narrowing of the lumen. RESULTS: The mass has been radically removed with thoracoscopic approach. Postoperative stay was uneventful and the patient was discharged three days after the operation. At histological examination the mass appeared as a cystic formation with fibromuscular wall and ciliated epithelium (so-called disembriogenetic bronchogenic cyst). CONCLUSION: The case we have reported describes a very unusual case of a voluminous symptomatic intramural oesophageal disembriogenetic cyst whose characteristics had not been defined at preoperative examinations. Surgical removal of the mass has been achieved with a minimally invasive approach.

Esophageal cyst in the duodenum of a foal.

A 21-day-old Thoroughbred colt was euthanized following a history of recurrent colic. A 4.5 cm in diameter, occlusive, submucosal cyst was identified in the duodenum at necropsy. Histologically, the cyst was surrounded by a smooth muscle wall and was lined by both squamous and attenuated cuboidal to columnar epithelium. A diagnosis of an esophageal cyst was made based on the gross and histologic findings.

Single institutional experience with primary mediastinal cysts: clinicopathological study of 108 resected cases.

PURPOSE: To review our institutional surgical outcomes with primary mediastinal cysts (PMCs) and elucidate the clinicopathological differences among several histological PMC variants. METHODS: We retrospectively reviewed 108 patients who underwent surgery for PMC at our institution between 1997 and 2012. RESULTS: There were 54 thymic cysts (TCs), 26 bronchogenic cysts (BCs), 16 mature cystic teratomas (MCTs), 11 pericardial cysts (PCs), and 1 esophageal duplication cyst. Surgical approach was via thoracoscopy in 44, thoracotomy in 24, median sternotomy in 39, and hemiclamshell incision in 1. Pathological complete resection was achieved in all patients. Postoperative complications occurred in 13 patients. There was no postoperative mortality. All patients were recurrence-free after a mean follow up of 41 ± 26 months. MCT was significantly associated with larger cyst size (p <0.001) more frequent combined resection of invaded organs (p <0.001), more intraoperative bleeding (p = 0.005), and longer duration of operation (p = 0.022) than the 3 other groups (TC, BC, and PC). CONCLUSION: Surgical treatment for PMC is safe and efficacious regardless of approach. Patients with MCT may require more aggressive surgeries than those with other histological variants, reflecting their potential for invasion into surrounding structures and larger cyst size.

Double esophageal duplication cysts, with ectopic gastric mucosa: a case report.

Esophageal duplication cyst (EDC) is a congenital malformation of the posterior primitive foregut, which mainly occurs in the thoracic esophagus. Here, we describe a 3-year-old Han Chinese boy afflicted with intermittent fever of acute onset and dry cough. Thoracic computed tomography revealed an 10 cm × 5.4 cm × 5.8 cm oval-shaped, cyst-like tumor located in the extrapleural space, extending along the right paravertebral gutter and compressing the trachea forward. An additional small-sized, oval-shaped cyst was identified in the posterior mediastinum, between the esophagus and the spinal column, at the T1 level. During open thoracotomy, under general anesthesia, an opaque, thick-walled, esophageal cyst was revealed not to be in communication with the esophageal lumen or the trachea. This cyst was subsequently resected in an en bloc manner. The small (1-cm) esophageal cyst was left untreated based on a "wait-and-see" policy. Histological analysis showed that the resected cyst was walled by hyperplastic, fibrous tissues and locally lined with gastric mucosa inherent glands. This finding was consistent with a diagnosis of EDC, with ectopic gastric mucosa. The respiratory tract symptoms resolved immediately after the operation. Computed tomography obtained at the 6-month follow-up showed that no disease, residual or recurrence, was present after the resection of the large-sized cyst, and the small-sized cyst remained unchanged in size.

[Congenital esophageal duplication cysts: progressive dysphagia in adulthood]. / Kongenitale zystische Duplikatur des Ösophagus: Progrediente Dysphagie im Erwachsenenalter.

Esophageal duplications are congenital abnormalities of the foregut. We present the case of a 33-year-old woman suffering from progressive dysphagia who had surgery for esophageal duplication. The following three criteria define the cystic lesion: an intimate attachment to the esophageal wall, the presence of a smooth muscle coat and a mucosal lining consisting of squamous and/or ciliated respiratory epithelium. Diverticula, bronchogenic cysts and cystic neoplasms have to be considered in the differential diagnosis. Congenital cystic esophageal duplication is a rare cause of dysphagia in adulthood.

Isolated cystic cervical oesophageal duplication: a rare congenital anomaly.

Oesophageal duplication is a rare congenital anomaly. The cystic form is the usual presentation of the duplication, found predominantly in the lower third. Less than 20 cases of isolated cystic oesophageal duplication in the cervical region have been reported till date in the English literature. We are reporting this case because of its rarity.