Esophageal Duplication Cyst with Abscessation: A case report

Abstract

An esophageal duplication cyst is a cyst originating in the foregut. These cysts are relatively rare, accounting for only 0.9 to 2.5% of mediasternal tumors. A patient presented with a duplication cyst from the abdomen, which had perforated into the esophageal lumen with a consequent abscessation. This cyst was surgically resected. The patient was a 57-year-old man and he presented at a nearby hospital with epigastric pain in November 2006. An examination revealed a mass perforating into the esophageal lumen with a hemorrhage directly above the esophagogastric junction. Although conservative treatment was administered for 4 months, the mass was associated with abscessation and progressed into an intractable condition. Therefore, the patient was referred for surgical treatment. An examination revealed a nearly semicircular submucosal tumor situated just superior to the esophagogastric junction and persistent draining was also noted from its central recess. Abdominal computed tomography, magnetic resonance imaging scans and echography demonstrated a cystic lesion, 50 mm in diameter, containing fluid, walled with a thick septum having an irregular luminal surface and abutting on the wall of the abdominal esophagus. A surgical resection was indicated for this condition because the possibility of malignancy could not be ruled out based on the diagnostic imaging results. A laparotomy with a lower esophagectomy and fundusectomy were performed in combination with reconstruction by jejunal interposition. After the operation the patient's condition was favorable and he is now being followed on an outpatient basis. The histopathological diagnosis of the present case was a duplication cyst associated with the microscopic features of inflammation.