Adenocarcinoma arising from a gastric duplication cyst: a case report and literature review

Abstract

IntroductionAlimentary tract cystic duplication is a rare congenital anomaly predominantly affecting females, and diagnosed mostly in the early years of life.Case reportWe present here a case of a 51-year-old man presenting with a 2-day history of melena. Gastroscopy showed fresh blood, as well as a mass lesion and cavity at the fundus. Biopsies of the mass edge reported the occurrence of moderately differentiated adenocarcinoma and mild chronic gastritis. Computed tomography imaging showed a 5.1×6.5 cm cystic mass in the gastric greater curvature. The patient received six cycles of epirubicin, capecitabine, and oxaliplatin, followed by uncomplicated total gastrectomy.Literature reviewData from all 11 reports of similar cases were reviewed and pooled. The result shows male predominance and variable symptoms, as well as a wide age range (25–76 years) at presentation. The cysts are commonly located along the greater curvature and are unilocular. Surgery was the treatment in most cases.ConclusionAlimentary tract cystic duplication is rare and may predispose to malignancy. Early diagnosis and prompt surgical intervention is important for the best outcome.

Pancreatobiliary Adenocarcinoma in a Gastric Duplication Cyst: A Doubly Rare Diagnosis

“…Although GDC are found anywhere in the stomach, most are located in the greater curvature, as in the present case, followed by posterior wall, lesser curvature, anterior wall and pylorus [11]. Because most cases occur along the greater curvature of the stomach, the cysts are found to compress the adjacent organs such as the pancreas, kidney, spleen, and adrenal gland [16]. Accordingly, the differential diagnosis would include cysts derived from these organs [4].…”

“…GTD are a rare congenital developmental malformation with a reported incidence of about 1 in 4500 live births [16]. These anomalies may occur at any level, from the oral cavity to the rectum, with the ileum being the most common site (33-35%) following by esophagus (20%), colon (13%), jejunum (10%), stomach (7-9%) and duodenum (5%) [1,6].…”

“…The majority of the gastric duplications are cystic and do not communicate with the lumen of the stomach [3,4]. Malignant transformation arising from a gastric duplication cyst (GDC) is extremely rare, with very few cases reported in the literature to date [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Adenocarcinoma has been described as the most common histologic type of malignant modification associated with GDC.…”

Adenocarcinoma Arising From a Gastric Duplication Cyst With Lymph Node Metastasis

“…More than 80% of gastric duplications are cystic and do not communicate with the gastric lumen. The remaining 20% comprise tubular GDCs, which are contiguous with the stomach and communicate to a certain extent with its lumen [ 13 ]. Duplication cysts of the ileum are usually located on the mesenteric border, whereas the usual location for GDCs is along the greater curvature, followed by the posterior wall of the stomach.…”

“…One-third of GDCs are associated with other developmental anomalies such as GDCs at other locations and duodenal diverticula [1]. Adenocarcinoma rarely arises from a GDC, and only 16 cases of malignancy have been reported to date [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. An established resection procedure for and the range of this malignancy have not been discovered thus far.…”