Diffuse cystic glandular malformation of the stomach associated with adenocarcinoma.Case report and review of the literature

Abstract

A 60-year-old man was found to have diffuse cystic glandular malformation and adenocarcinoma of the stomach. Review of the literature revealed one similar reported case and five others with diffuse heterotopic cystic malformation only. Clinically, the lesion is associated with gastrointestinal symptoms, and radiologically , it can mimic diffuse gastric carcinoma, lymphoma, or polyposis.

Diffuse heterotopic submucosal cystic malformation of the stomach: Ultrasonographic diagnosis

“…The diffuse heterotopic submucosal cystic malformations (submucosal cysts) of the stomach have been reported under several names, including multiple diffuse cystic disease [1], diffuse submucosal cystic disease [2], diffuse cystic glandular malformation [3], heterotopic gastric glands [6], and heterotopic submucosal gastric cysts [7]. These cysts have been found in stomachs resected for gastric carcinoma, and their possible association with gastric carcinoma has been suggested [1][2][3].…”

“…An association of submucosal cysts of the stomach with gastric carcinoma has been suggested by others [1][2][3]. Iwanaga et al suggested that submucosal cysts may not be precancerous lesions, but be paracancerous [2].…”

“…These cysts have been found in stomachs resected for gastric carcinoma, and their possible association with gastric carcinoma has been suggested [1][2][3].…”

“…One describes them as congenital, similar to a hamartoma [1,3,8], and the other regards them as acquired lesions [2,6,7]. The latter theory suggests that gastritis may give rise to these cysts and that the development of heterotopic cysts in the submucosa may make the mucosal surface more prone to repeated erosion regeneration which may result in carcinoma or atypical hyperplasia [2,6,7].…”

“…We report a case of submucosal cysts associated with an early gastric carcinoma in which ultrasonography (US) and endoscopic ultrasonography (EUS) were very useful in the preoperative diagnosis.The association of diffuse heterotopic submucosal cystic malformations (submucosal cysts) of the stomach and gastric carcinoma have been noted in several reports [1][2][3]. However, it is difficult to diagnose these cysts preoperatively using only upper gastrointestinal (GI) series and endoscopy.…”