Quiste de duplicación gástrico: diagnóstico por punción-aspiración guiada por ecoendoscopia

Abstract

Duplication cysts are rare gastrointestinal congenital abnormalities. They can occur anywhere throughout the gastrointestinal tract, and gastric duplication cysts are most uncommon, representing only 4-8% of all gastrointestinal duplication cysts. Nowadays several theories try to explain the pathogenic mechanisms involved. These cysts are usually diagnosed during early childhood, and very rarely are detected in adults, mostly incidentally due to a lack of symptoms. Close to 50% of gastric cysts are associated with other abnormalities. It is extremely important that a meticulous differential diagnosis is performed regarding other diseases, mainly malignancies with a cystic component. Although extremely uncommon, a malignant transformation of these lesions has been reported, which highlights the importance of a correct diagnosis. Herein we report the case of a duplication cyst in an adult, which was detected by endoscopic ultrasound-guided fine-needle aspiration, recently proposed as the most accurate technique for the identification of these lesions.

Adenocarcinoma Arising in Gastric Duplication Cyst

“…An abdominal CT or magnetic resonance imaging can be a useful tool in differentiating duplication cysts from other cystic lesions. However, depending on the series, up to 70% of the cases can be misdiagnosed as solid lesions due to the variable amount of highly concentrated proteins in cystic contents 6. Therefore, histological confirmation through endoscopic ultrasonography-guided aspiration or biopsy is generally recommended to rule out the possibility of malignant changes in gastric duplication cysts 6,7…”

Duplication cysts: Diagnosis, management, and the role of endoscopic ultrasound

“…argued that a cytological and histological examination of the cyst via EUS-FNA was necessary in order to rule out malignant cyst transformation. [26] Napolitano et al . also reported a case of a gastric duplication cyst that was initially misdiagnosed as a GIST with EUS.…”

Unusual Noncommunicating Isolated Enteric Duplication Cyst in Adults

“…Duplication cysts were first described by Wendel in 1911, and few cases have been reported since that time [3]. Enteric duplication cysts are hollow, epithelium-lined, cystic, spherical, or tubular structures that are basically attached to the wall of the gastrointestinal tract (often sharing the serosa) and supplied by common mesenteric blood vessels [7].…”

“…A small bowel duplication cyst is the most common type of enteric duplication cyst, and the ileum is the most common location [1, 2]. The prevalence of duplication cysts is 2-fold higher in women, and they show no familial aggregation [3]. Diagnosis is made in more than half of the cases during early childhood because duplication cysts tend to be symptomatic in this age group.…”