Thoracoscopically Resected Esophageal Duplication Cyst with High Value of Serum CA19-9 at the First Visit—Report of a Case—

Abstract

A 41-year-old man with chest pain visited a nearby hospital in February 2017. Chest CT scan detected a mediastinal cystic tumor, and he was referred to our hospital for further examination and treatment. In the blood test, the serum CA19-9 level was as high as 5,960 U/ml, and upper gastrointestinal endoscopy showed a submucosal bulging with bluish purple mucosa encircling the half of the lumen in the middle to lower esophagus.

Ultrasound endoscopy visualized the lesion as a tumor with mosaic pattern contents, indicating the presence of hematoma. CT scan showed an 83 × 41 × 115 mm bilocular cystic lesion in the anterior surface of the esophagus which compressed and narrowed the esophagus. Although it was diagnosed as esophageal cyst, he had chest pain and dysphagia, and so cystectomy using thoracoscopy was performed in March. The postoperative course was uneventful and he was discharged on the 10th postoperative day. Histologically, pseudostratified epithelium was found on the inner surface of the cyst and the cystic wall had two muscular layers. Duplication cyst was thus diagnosed.