Bronchogenic cyst of the stomach involved with gastric adenocarcinoma

Abstract

Bronchogenic cyst, a congenital anomaly mostly found in the mediastinum, rarely arises in the stomach. A 43-year-old man had epigastric pain and was diagnosed as having gastric adenocarcinoma. Abdominal ultrasonography showed hepatic cyst, and computed tomography and magnetic resonance imaging revealed a cystic lesion near the stomach. At surgery, the cystic lesion was found to be located at the lesser curvature of the stomach where the cancer invasion was seen. Total gastrectomy with combined resection of the cystic lesion was performed. Pathologically, the cyst wall was lined by pseudostratified ciliated columnar epithelium, subepithelial mixed seromucinous glands and smooth muscle bundles. The pathological diagnosis was bronchogenic cyst of the stomach involved with gastric adenocarcinoma. Based on a similar association between gastric diffuse submucosal cysts and gastric cancer in the previous reports, it is possible that chronic inflammation from bronchogenic cysts to the gastric mucosa may cause adenocarcinoma in the stomach. At surgery, complete combined resection without rupture of the bronchogenic cyst involved with the gastric adenocarcinoma is needed for treatment of gastric cancer to prevent dissemination of cancer cells considering when cancer cells have invaded beyond the pseudostratified ciliated columnar epithelium and within the bronchogenic cyst.

Gastric duplication cyst lined by pseudostratified columnar ciliated epithelium: a case report and literature review

“…Malignant change of GDC lined by PCCE is rare. Shibahara et al (2009) reported a case of bronchogenic cyst of the stomach located at the opposite side wall to the gastric adenocarcinoma, and attributed the adenocarcinoma to the chronic inflammation from the bronchogenic cyst to the gastric mucosa. Worth mentioning, because of persistent exposure to carcinogenic substances, alimentary duplication cyst should be recognized as a lesion at risk for malignant transformation in patients aged more than 50 years (Fukumoto et al, 2008).…”

“…If this is not possible, segmental gastrectomy is an alternative (Holcomb et al, 1989). When malignant change is seen in the cyst, a surgical procedure without rupture of the cyst is required (Shibahara et al, 2009). Management of asymptomatic cases remains controversial.…”

Gastric bronchogenic cysts: A case report and literature review

“…Clinicians should be vigilant for these complications as they may further complicate surgical intervention due to the associated adhesion ( 32 ). In the 35 cases analyzed in the present study, 3 cases were preoperatively diagnosed by needle biopsy, whereas the majority of the remaining cases were misdiagnosed as stromal tumors or other benign lesions and one previous case was misdiagnosed due to concomitant gastric carcinoma ( 23 ).…”

“…Postoperatively, the elevated CA 19–9 levels were found to be normalized. Certain cases also presented with gastric carcinoma ( 23 , 24 ); chronic inflammation of the gastric mucosa resulting from the bronchogenic cyst may have caused adenocarcinoma in the stomach ( 23 ). The present study demonstrated that gastroscopy and imaging examinations may be able to locate the lesion; however, they cannot provide qualitative diagnoses.…”

Foregut duplication of the stomach diagnosed by endoscopic ultrasound guidedfine-needle aspiration cytology: case report and literature review

“…Owing to the report of gastric cancer arising in gastric duplication [2,21-23], surgery is nowadays considered the standard treatment for these lesions [24]. The possibility of a malignant transformation is related to the presence of a gastric-type lining epithelium.…”