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Case Reports
. 2017 Nov 6:10:367-372.
doi: 10.2147/IMCRJ.S138616. eCollection 2017.

Adenocarcinoma arising from a gastric duplication cyst: a case report and literature review

Maheeba Abdulla Mohamed Abdulla  1 , Mahmood Al Saeed  1 , Safa Ameer Alshaikh  2 , Umesh J Nabar  3
Affiliations
Case Reports

Adenocarcinoma arising from a gastric duplication cyst: a case report and literature review

Maheeba Abdulla Mohamed Abdulla et al. Int Med Case Rep J. .

Abstract

Introduction: Alimentary tract cystic duplication is a rare congenital anomaly predominantly affecting females, and diagnosed mostly in the early years of life.

Case report: We present here a case of a 51-year-old man presenting with a 2-day history of melena. Gastroscopy showed fresh blood, as well as a mass lesion and cavity at the fundus. Biopsies of the mass edge reported the occurrence of moderately differentiated adenocarcinoma and mild chronic gastritis. Computed tomography imaging showed a 5.1×6.5 cm cystic mass in the gastric greater curvature. The patient received six cycles of epirubicin, capecitabine, and oxaliplatin, followed by uncomplicated total gastrectomy.

Literature review: Data from all 11 reports of similar cases were reviewed and pooled. The result shows male predominance and variable symptoms, as well as a wide age range (25-76 years) at presentation. The cysts are commonly located along the greater curvature and are unilocular. Surgery was the treatment in most cases.

Conclusion: Alimentary tract cystic duplication is rare and may predispose to malignancy. Early diagnosis and prompt surgical intervention is important for the best outcome.

Keywords: adenocarcinoma; alimentary tract cystic duplication; cystic duplication; gastric duplication cyst; gastric mass.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Representative endoscopic images. Notes: (A) Image depicts a mass lesion with cavity opening observed in the fundus. (B) The cavity contained marginal ulcers with fresh and clotted blood. (C) An image of normal antrum.
Figure 2
Figure 2
Histology images of moderately differentiated adenocarcinoma. Notes: H–E staining depicts invasive atypical glands with central necrosis in (A) (original magnification ×100) and (B) (original magnification ×40). (C) Invasive malignant glands lined by atypical pleomorphic cells with prominent nucleoli and central necrosis can be seen (original magnification ×400). Abbreviation: H–E, hematoxylin and eosin.
Figure 3
Figure 3
CT scan of the duplication cyst. Notes: (Ai and Aii) Axial, (B) sagittal, and (C) coronal scans of the chest, abdomen, and pelvis demonstrated a well-circumscribed, round cystic mass of homogeneous density along the greater curvature of the stomach (arrows), consistent with a duplication cyst. The mass measured 5×4 cm. Abbreviation: CT, computed tomography.
Figure 4
Figure 4
Histology of cyst lined by benign epithelial lining. Note: H–E staining shows cyst lined by benign epithelial lining, surrounded by smooth muscle fibers and chronic inflammatory cells: (A) (original magnification ×10); and (B) higher magnification (original magnification ×100). Abbreviation: H–E, hematoxylin and eosin.
See this image and copyright information in PMC

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