Successful laparoscopic resection for gastric duplication cyst: a case report

Abstract

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.

Laparoscopic mucosectomy for gastric duplication cysts that communicated with the spleen in a 10‐year‐old girl: A case report

“…Gastric duplications are usually single, cystic, elliptical, and spherical. They are often linked with gastric muscular layers and located along the greater gastric curvature 3 . Our case differed from the typical cases in that there were multiple cysts distinct from the stomach.…”

“…Surgical excision is the first choice of treatment for gastric duplication cysts. Recently, the number of studies performing laparoscopic resection for gastric duplication cysts has increased 3‐5 . Laparoscopy is characterized by less trauma and quicker recovery than laparotomy.…”

“…Although cystectomy is ideal, gastric duplication cysts can require more invasive surgery, such as pancreatectomy or splenectomy, when communicating with adjacent organs 3,4 . Some cases have been resolved by enucleation or mucosectomy to preserve adjacent organs 5‐7 .…”

Diagnosis of gastric duplication cyst by positron emission tomography/computed tomography: A case report

“…If GDCs are diagnosed as benignant lesions, endoscopic submucosal dissection, which is less invasive, may be recommended. Otherwise, laparoscopic resection or surgical resection may be the preferred treatment[15].…”

Quiste de duplicación gástrico en paciente adulto: Reporte de caso y revisión de la literatura

“…Los quistes de duplicación (QD) son malformaciones congénitas raras, que se definen como una lesión quística tapizada por epitelio gástrico o intestinal, con una capa de músculo liso entre su pared y la del segmento del tubo digestivo afectado 1,2 . Su incidencia se estima en 1 por cada 4500 nacidos.…”