Asymptomatic congenital oesophageal cyst infiltrating the lung: an unusual complication

Abstract

An asymptomatic 14-year-old boy presented with minor chest trauma. Chest X-ray showed opacity in the upper zone of the left lung. Further investigations with magnetic resonance imaging showed it to be a posterior mediastinal mass with a fistula to the lung, along with cystic changes in the left upper lobe of lung. Left upper lobectomy with excision of the mass was performed. Histological examination later showed an oesophageal duplication cyst with a fistula to the left upper lobe of the lung. We present this unusual complication of an oesophageal cyst infiltrating the lung in an asymptomatic child.

Surgical treatment of a thoracic oesophageal duplication cyst causing recurrent dysphagia in an adult dog

“…In humans, upper oesophageal cysts usually lead to respiratory distress due to tracheobronchial compression, while middle and lower cysts can lead to gastrointestinal disturbances, such as dysphagia, regurgitation, vomiting and cardiovascular and respiratory symptoms, including arrhythmias and respiratory distress (Sundaramoorthi et al 2000;Carachi and Azmy 2002). Nonetheless, about 35% of the patients with middle or lower oesophageal cysts are asymptomatic, and, in our patient, only gastrointestinal symptoms were reported (Sundaramoorthi et al 2000;Jan et al 2016).…”

“…A cut section revealed that the cyst contained abundant, viscous and yellow material which was partly adherent to the cystic wall https://doi.org/10.17221/113/2017-VETMED as a consequence of enlargement of the structure due to inflammation or haemorrhaging of the cyst (Sundaramoorthi et al 2000;Carachi and Azmy 2002;Martin et al 2007). In humans, upper oesophageal cysts usually lead to respiratory distress due to tracheobronchial compression, while middle and lower cysts can lead to gastrointestinal disturbances, such as dysphagia, regurgitation, vomiting and cardiovascular and respiratory symptoms, including arrhythmias and respiratory distress (Sundaramoorthi et al 2000;Carachi and Azmy 2002). Nonetheless, about 35% of the patients with middle or lower oesophageal cysts are asymptomatic, and, in our patient, only gastrointestinal symptoms were reported (Sundaramoorthi et al 2000;Jan et al 2016).…”

“…In human medicine, a complete surgical excision by thoracotomy or thoracoscopy is the treatment of choice and is always indicated to prevent complications (Sundaramoorthi et al 2000;Agarwal and Bagdi 2011). Leaving the cyst untreated may eventually lead to significant complications including mediastinitis, due to infection of the mediastinal cyst, life-threating haemoptysis, bronco-oesophageal fistula or more rarely, malignant transformations (Sundaramoorthi et al 2000;Carachi and Azmy 2002;Agarwal and Bagdi 2011;Obasi et al 2011).…”

“…Rarely, single cases of duplication cysts originating from the tongue, floor of the mouth and hypopharynx have been reported (Sundaramoorthi et al 2000;Espeso et al 2007;Obasi et al 2011). Multiple enteric duplication cysts were recently reported in a human infant (Udiya et al 2016).…”

“…The location and the size of the cysts usually determine the time of presentation and the associated symptoms (Sundaramoorthi et al 2000). Complete surgical excision is the treatment of choice in human medicine (Jan et al 2016).…”