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

Gastric Duplication Cyst Removed by Endoscopic Submucosal Dissection

• Eom JS
• Kim GH
• Song GA
• Baek DH
• Ryu KD
• Lee KN
• Park DY

• KMID: 1043334
• DOI: http://doi.org/10.4166/kjg.2011.58.6.346

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.

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  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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