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Li Y, Li C, Wu H, Wang Q, Gao ZD, Yang XD, Jiang KW, Ye YJ. Clinical features of gastric duplications: evidence from primary case reports and published data. Orphanet J Rare Dis 2021; 16:368. [PMID: 34412674 PMCID: PMC8377950 DOI: 10.1186/s13023-021-01992-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/01/2021] [Indexed: 01/07/2023] Open
Abstract
Background Alimentary tract duplications are rare congenital lesions, and only 2–8% of them are located in the stomach. Gastric duplications (GD) can lead to severe adverse events. Thus, surgical resection is required once the disease is diagnosed. The main purpose of this study is to describe the clinical features of gastric duplications and to provide evidence for the diagnosis and treatment. Methods A retrospective review of eight gastric duplications at two medical centers Peking University People’s Hospital (PKUPH) and Shandong Provincial Hospital from 2010 to 2020 was conducted. Furthermore, the literature search was also conducted by retrieving data from PubMed, EMBASE and Cochrane Library databases from the date of the database inception to January 15, 2021. Results Eight patients who were diagnosed as gastric duplications and 311 published records were included in this study. In all, 319 patients were identified: Vomiting and abdominal pain were the most frequent clinical presentations among juveniles and adults respectively. There was no difference in gender distribution (F: 53.16% vs M: 46.84%), and the cystic gastric duplications were the most common type of the gastric duplications (87.04%). More than half (53.30%) of included cases were located in the greater curvature of stomach. Conclusions Gastric duplications could present with a wide spectrum of symptomatology, which might be misdiagnosed easily as other diseases. For cystic gastric duplications, the optimal treatment was a complete surgical removal. But conservative treatment might be an alternative strategy for tubular gastric duplications.
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Affiliation(s)
- Yang Li
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Chen Li
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Hao Wu
- Department of Gastroenterological Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Quan Wang
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Zhi-Dong Gao
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Xiao-Dong Yang
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Ke-Wei Jiang
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
| | - Ying-Jiang Ye
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
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Rolo A, Oliveira RC, Lima B, Barbosa A, Faustino I. Pancreatobiliary Adenocarcinoma in a Gastric Duplication Cyst: A Doubly Rare Diagnosis. Cureus 2021; 13:e16025. [PMID: 34336513 PMCID: PMC8319232 DOI: 10.7759/cureus.16025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2021] [Indexed: 02/06/2023] Open
Abstract
Gastric duplication cyst (GDC) is a rare congenital abnormality and the development of malignant transformation in these lesions is even rarer, with only few reported cases worldwide to date. We hereby report an additional case of cancer arising from a GDC in a 54-year-old male. The patient’s chief complaints were abdominal pain and significant weight loss. Computed tomography and endoscopy ultrasonography (EUS) revealed a nodular formation with a cystic component, localized in the great gastric curvature and invading the spleen and left adrenal gland. The biopsy from EUS was inconclusive. After exploratory laparotomy, the patient was submitted to an en-bloc resection with partial gastrectomy, splenectomy and left adrenalectomy. Histopathologic examination revealed a cystic mass non-communicating with the gastric wall. Immunohistochemistry staining showed a moderately differentiated pancreatobiliary adenocarcinoma within a duplication cyst with lymphovascular and perineural invasion. The patient was proposed to adjuvant systemic treatment, however, after few months he developed metachronous metastasis. To our knowledge, this is the first case of adenocarcinoma with pancreatobiliary differentiation arising from a gastric duplication cyst.
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Affiliation(s)
- Ana Rolo
- Oncology Department, Hospital Senhora da Oliveira, Guimarães, PRT
| | - Rui Caetano Oliveira
- Pathologic Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PRT
| | - Bárbara Lima
- Oncology Department, Hospital Senhora da Oliveira, Guimarães, PRT
| | - Ana Barbosa
- Oncology Department, Hospital Senhora da Oliveira, Guimarães, PRT
| | - Ilda Faustino
- Oncology Department, Hospital Senhora da Oliveira, Guimarães, PRT
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Kinugasa S, Monma H, Sakamoto Y, Watanabe T, Fujimoto M. Adenocarcinoma Arising From a Gastric Duplication Cyst With Lymph Node Metastasis. Cureus 2020; 12:e12320. [PMID: 33520518 PMCID: PMC7837636 DOI: 10.7759/cureus.12320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Gastric duplication cysts (GDCs) are a relatively rare congenital anomalies and are mostly diagnosed in the early years of life. Herein, we report a very rare surgical case of adenocarcinoma arising from a GDC with lymph node metastasis. A 78-year-old woman was referred to our hospital because of elevated serum levels of cancer antigen (CA) 19-9. Endoscopic ultrasound, contrast fistulography, and computed tomography showed a cystic lesion communicating with the lesser curvature of the stomach. The serum levels of CA 19-9 were high, and fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) imaging demonstrated a slightly enlarged lymph node with high FDG uptake after four months. The size of the cyst was unchanged. It was diagnosed as a GDC. The enlarged lymph node was highly likely to be malignant. Hence, we performed a distal gastrectomy involving the origin of entry and whole body of the GDC with en bloc regional lymphadenectomy. The postoperative pathology was consistent with GDC with moderately differentiated adenocarcinoma and lymph node metastasis. Adjuvant chemotherapy with tegafur-gimeracil-oteracil potassium (S-1) was administered for 12 months. At present, the patient is alive, with no recurrence of the lesion even four years after the operation. GDCs in adults are rare and may predispose to malignancy. Early diagnosis and prompt surgical intervention are important for favorable outcomes.
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Affiliation(s)
- Shoichi Kinugasa
- Surgery, Hyogo Prefectural Kakogawa Medical Center, Kakogawa, JPN
| | - Hiroyuki Monma
- Surgery, Hyogo Prefectural Kakogawa Medical Center, Kakogawa, JPN
| | - Yoshio Sakamoto
- Gastroenterology, Hyogo Prefectural Kakogawa Medical Center, Kakogawa, JPN
| | - Takafumi Watanabe
- Gastroenterology, Hyogo Prefectural Kakogawa Medical Center, Kakogawa, JPN
| | - Masayo Fujimoto
- Pathology, Hyogo Prefectural Kakogawa Medical Center, Kakogawa, JPN
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Xv FY, Sun A, Gan Y, Hu HJ. Gastric duplication cyst mimicking large cystic lymphangioma in an adult: A rare case report and review of the literature. World J Clin Cases 2019; 7:2087-2093. [PMID: 31423442 PMCID: PMC6695537 DOI: 10.12998/wjcc.v7.i15.2087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/25/2019] [Accepted: 07/03/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Gastric duplication cysts (GDCs) are a relatively uncommon congenital developmental abnormality, mainly occurring in infants but very rarely in adults. Because of the variability in clinical presentation, it is often quite challenging to diagnose GDCs in adults. We are presenting a case report of an adult diagnosed operatively as having a GDC with a literature review to summarize clinical and imaging features and the treatment selections of GDCs in adults so that doctors could have a comprehensive understanding of this disease and make a precise diagnosis and a suitable therapeutic decision for patients.
CASE SUMMARY A 51-year-old man presented with recurrent epigastric pain and fullness for two years. No significant findings were noted during physical examination and routine blood tests were unremarkable. An abdominal ultrasound revealed a large cyst in the upper left abdominal quadrant. A following contrast-enhanced abdominal computed tomography (CT) scan demonstrated a hypodense cystic lesion between the spleen and stomach. The lesion had scattered calcification in the cyst wall without any significant enhancement. The lesion was initially thought to be a cystic lymphangioma. The patient underwent a surgical resection and intraoperatively it was noted that the lesion was closely adherent to the greater curvature of the stomach. Subsequently, a resection of the gastric mass along with a partial gastrectomy was performed. The patient recovered quickly with a complete symptomatic relief and did not show any further complications during the 8-month follow-up.
CONCLUSION GDCs are quite rare in adults, with a multitude of symptoms, which is quite challenging for precise diagnosis before histological examination. Some imaging techniques involving CT, magnetic resonance imaging, and endoscopic ultrasound could provide valuable morphological features for differential diagnosis.
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Affiliation(s)
- Fang-Yi Xv
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Alex Sun
- Diagnostic Radiology - Musculoskeletal Imaging, University of California, San Diego, CA 92093, United States
| | - Yi Gan
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Hong-Jie Hu
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
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Duan J, Yan S, Zhang Q, Wu J, Du Y, Owusu-Ansah KG, Zheng S. Adult Gastric Bronchogenic Cyst With Elevated Tumor Marker in Containing Fluid: A Case Report and Literature Review. Int Surg 2019; 104:58-64. [DOI: 10.9738/intsurg-d-16-00025.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2025] Open
Abstract
Introduction:
Duplication cysts are rare malformations that exist in the alimentary tract, and the mucosa of gastric bronchogenic cyst lined by pseudostratified columnar ciliated epithelium (PCCE) is even more rare. We reviewed related literatures to depict this unique abnormality.
Case presentation:
Herein we report an abdominal mass that was found incidentally in a 52-year-old female. The biochemical test of contents revealed a high concentration of tumor markers unusually. A laparoscopic surgery was undertaken to remove the lesion. The cyst was found to originate from the stomach but did not show any anatomic communication with the stomach lumen. Pathologic examination confirmed the mucosa was lined by PCCE.
Conclusion:
The symptoms and radiologic presentations of GDC are nonspecific. It should be distinguished with other abdominal cystic masses. Surgery is advised in respective of malignancy.
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Affiliation(s)
- Jixuan Duan
- Department and institution: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University
| | - Sheng Yan
- Department and institution: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University
| | - Qiyi Zhang
- Department and institution: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University
| | - Jingjin Wu
- Department and institution: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University
| | - Yu Du
- Department and institution: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University
| | | | - Shusen Zheng
- Department and institution: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University
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Jiang W, Zhang B, Fu YB, Wang JW, Gao SL, Zhang SZ, Wu YL. Gastric duplication cyst lined by pseudostratified columnar ciliated epithelium: a case report and literature review. J Zhejiang Univ Sci B 2011; 12:28-31. [PMID: 21194183 DOI: 10.1631/jzus.b1000130] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Gastric duplication cyst (GDC) lined by pseudostratified columnar ciliated epithelium (PCCE) is an uncommon lesion stemming from a foregut developmental malformation. Its clinical and radiological presentation is usually nonspecific. In this study, we reported a 76-year-old man who presented with an incidentally found perigastric mass. An exploratory laparotomy revealed a non-communicating cyst below the gastroesophageal junction, measuring 4 cm×4 cm in size. Microscopically, the gastric cyst was lined merely by PCCE. Although rare, GDC lined by PCCE should be included in the differential diagnosis of gastric wall masses. Surgical intervention is warranted in patients who have clinical symptoms, or who are aged more than 50 years.
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Affiliation(s)
- Wu Jiang
- Department of Surgical Oncology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
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