Gastric Duplication Cysts of the Pancreas: Clinical Presentation and Surgical Management

Lee, T. Chen-An; Kim, E. S.; Ferrell, L. B.; Brandt, M; Minifee, Paul K.; Midgen, Craig; Domingo, R.; Kearney, Debra L.

doi:10.1055/s-0031-1279692

Cited by 8 publications

(3 citation statements)

References 12 publications

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“…GDCs may occur in any anatomical region of the gastrointestinal tract, from mouth to anus, and are present in 1 per 4500–10,000 live births [4]. Gastric duplication is a relatively rare congenital malformation, accounting for approximately 2.9–3.8% of gastrointestinal duplications [5].…”

Section: Discussionmentioning

confidence: 99%

Successful laparoscopic resection for gastric duplication cyst: a case report

et al. 2019

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Background Gastric duplication is a relatively rare congenital malformation, accounting for approximately 2.9–3.8% of gastrointestinal duplications. Gastric duplication cyst is a congenital anomaly that is rarely observed in adults. Accurate diagnosis of these cysts before resection is difficult. In this report, we describe a patient with gastric duplication cysts that were treated by laparoscopic resection. Case presentation A 46-year-old Japanese woman was referred to our institution because a cystic lesion in the pancreatic tail was detected by ultrasonography during a health examination. The lesion had a clearly defined boundary of approximately 40 mm. A thick cystic lesion of the septum was observed in the pancreatic tail, but invasion into the stomach wall was not recognized on a computed tomographic scan. Endoscopic ultrasonography revealed that the tumor appeared smooth with a marginal edge, which was characterized by echo with high homogeneity, and the presence of viscous mucus was suspected. The preoperative diagnosis of mucinous cystic neoplasm was the reason for laparoscopic tumor resection. The resected specimen was a smooth surface tumor, and it was full of mucus. Histopathological study revealed that the mucosa was covered with crypt epithelium, muscularis mucosae, intrinsic muscularis, and serosa, and the wall of the tumor had a structure very similar to that of the stomach wall. The mucosa was partially drained by intrinsic gastric glands, but most of them were denucleated. No pancreatic tissue was present, and the tumor had no continuity with the spleen. These findings indicated a diagnosis of gastric duplication cyst with no continuity with the stomach wall. Conclusions In our experience, it is difficult to differentiate gastric duplication cyst from mucinous cystic neoplasm before laparoscopic resection. Events such as infection, bleeding, perforation, ulceration, fistula formation, obstruction, and compression have been linked to gastric duplication cysts, and malignant transformation of these cysts has been reported. Therefore, we suggest that resection should be the first treatment option for gastric duplication cysts.

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Section: Discussionmentioning

confidence: 99%

Successful laparoscopic resection for gastric duplication cyst: a case report

et al. 2019

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“…Gastrointestinal duplication cysts may occur in any region from mouth to anus and are present in 1 out of 4 500–10 000 live births [ 4 ]. Among them, they most commonly occur in the ileum and ileocecum.…”

Section: Discussionmentioning

confidence: 99%

Successful laparoscopic partial gastrectomy and spleen-preserving distal pancreatectomy for gastric duplication cyst connecting with the pancreatic tail

Kawaida

Kimura

Watanabe

et al. 2018

International Journal of Surgery Case Reports

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“…Despite this, a 50% incidence of misdiagnosis still remains (26), often leading to inappropriate operations and management. In our patient, imaging modalities played an indispensable role, they were able to provide valuable information about the location and characteristics of the mass, but they didn't show any clue to help identify it as a PDC.…”

Section: Date Investigations And/or Proceduresmentioning

confidence: 99%

Pancreatic duplication cyst misdiagnosed as distal pancreatic tumor: A case report and surgical approach

Zain

Sweity²,

Alshawwa³

et al. 2023

Front. Surg.

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Enteric duplication cysts (EDCs) are a benign and uncommon congenital malformation, with a nonspecific and extremely variable clinical presentation. EDCs associated with the pancreas are called pancreatic duplication cysts (PDCs). They are especially rare and can present with recurrent abdominal pain or even severe pancreatitis. These cysts often get confused with pancreatic neoplasms or pseudocysts, thus posing diagnostic and surgical challenges. Here, we report a case of a 20-year-old male patient with a 14-year history of recurrent abdominal pain and many hospital admissions, who had several imaging studies revealing a persistent focal heterogeneous lesion affecting the tail of the pancreas, surrounding a small pseudocyst. An ultrasound (U/S) guided biopsy was avoided due to the location of the mass. Surgical resection was carried out for the suspicion of malignancy and final pathology report showed benign findings while revealing that what was thought to be a pseudocyst turned out to be a gastric-type PDC, and after reviewing the available literature, we encountered 16 similar cases regarding misdiagnosing PDCs. We conclude that PDCs are very rare and have a variable clinical presentation as well as a likelihood of being confused with other pancreatic neoplasms. Therefore, PDCs need a high index of suspicion to avoid recurrent hospital admissions and unnecessary procedures due to the fact that sometimes a simple cystectomy is adequate.

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Gastric Duplication Cysts of the Pancreas: Clinical Presentation and Surgical Management

Cited by 8 publications

References 12 publications

Successful laparoscopic resection for gastric duplication cyst: a case report

Successful laparoscopic resection for gastric duplication cyst: a case report

Successful laparoscopic partial gastrectomy and spleen-preserving distal pancreatectomy for gastric duplication cyst connecting with the pancreatic tail

Pancreatic duplication cyst misdiagnosed as distal pancreatic tumor: A case report and surgical approach

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