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Yu LP, Li Q, Liu SJ, Wang HR, Xu T. [A case of gastric duplication presenting as a retroperitoneal cystic lesion]. JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2019; 51:764-768. [PMID: 31420637 DOI: 10.19723/j.issn.1671-167x.2019.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Gastric duplication is a rare congenital anomaly accounting to 4% of all gastrointestinal tract duplications. It is usually diagnosed pre-natally or during infancy. Retroperitoneal gastric duplication is very rare in adult patients. It is generally asymptomatic or presents with non-specific symptoms. The sensitivity of classical imaging modalities for retroperitoneal gastric duplication is weak. Retroperitoneal gastric duplication could be misdiagnosed as other retroperitoneal cystic lesions and it could be definitely diagnosed by typical findings of abdominal enhanced computed tomography (CT) and endoscopic ultrasonography (EUS) plus EUS:guided fine needle aspiration biopsy in gastric duplicated cyst. A female adult patient was diagnosed by an exceptional hospital CT as retroperitoneal cystic lesion and was admitted in our hospital in March 2019. The abdominal enhanced CT in our hospital preoperatively indicated a cystic lesion above the left kidney and the maximum cross section was 9.0 cm×5.2 cm. Lymphocysts and others should be identified and the lesion might be from the stomach. The retroperitoneal gastric duplication was not diagnosed before operation. In the operation laparoscopy revealed the cystic lesion in the retroperitoneum. The pancreas, left adrenal gland, and left kidney were compressed by the cystic lesion. The top of the lesion was connected with the small curvature of the stomach, but it was not communicated with the stomach. The retroperitoneal cystic lesion was completely excised and the surrounding organs were not damaged. The retroperitoneal gastric duplication was clearly diagnosed by the findings in the operation and the pathology of the lesion. The patient was discharged a week after surgery without gastrointestinal and pancreatic injuries. Therefore, the differential diagnosis of retroperitoneal cysts should consider the possibility of retroperitoneal gastric duplication. For patients with typical CT findings or unclear boundaries between the tumor and the stomach wall, gastric duplication could be diagnosed by EUS plus EUS:guided fine needle aspiration biopsy in the cyst. Retroperitoneal gastric duplication cyst could be completely excised by laparoscopy through abdominal cavity and the stomach wall could be completely repaired.
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Affiliation(s)
- L P Yu
- Department of Urology, Peking University People's Hospital, Beijing 100044, China
| | - Q Li
- Department of Urology, Peking University People's Hospital, Beijing 100044, China
| | - S J Liu
- Department of Urology, Peking University People's Hospital, Beijing 100044, China
| | - H R Wang
- Department of Urology, Peking University People's Hospital, Beijing 100044, China
| | - T Xu
- Department of Urology, Peking University People's Hospital, Beijing 100044, China
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Tessely H, Montanier A, Chasse E. Gastric duplication cyst with elevated CEA level: a case report. J Surg Case Rep 2018; 2018:rjy114. [PMID: 29942466 PMCID: PMC6007364 DOI: 10.1093/jscr/rjy114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 04/23/2018] [Accepted: 05/07/2018] [Indexed: 01/07/2023] Open
Abstract
Gastrointestinal tract duplications are congenital malformations rarely seen in adulthood. Gastric duplications (GD) represent 2-9% of it. Malignant transformation of GD is a rare complication described in the literature. We present the case of a 43-year-old man, who presented an abdominal mass and an elevated CEA level. A total gastrectomy was performed and the histological examination described a gastric duplication cysts (GDC) without malignant transformation. It is not the first case of elevation of CEA in GDC without evidence of malignancy described in the literature. Some authors think that GDC are premalignant lesions that envolve with the time to carcinomas. It is recommend that once the GDC is diagnosed to remove surgically the entire cyst even if the patient is asymptomatic.
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Affiliation(s)
- Héloïse Tessely
- Department of Abdominal Surgery, Epicura Hospital, 7301 Hornu, Belgium
| | - Aude Montanier
- Department of Abdominal Surgery, Epicura Hospital, 7301 Hornu, Belgium
| | - Emmanuel Chasse
- Department of Abdominal Surgery, Epicura Hospital, 7301 Hornu, Belgium
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Kawaida H, Kimura A, Watanabe M, Akaike H, Hosomura N, Kawaguchi Y, Amemiya H, Sudo M, Kono H, Matsuda M, Fujii H, Ichikawa D, Fukasawa M, Takahashi E, Sano K, Inoue T. Successful laparoscopic partial gastrectomy and spleen-preserving distal pancreatectomy for gastric duplication cyst connecting with the pancreatic tail. Int J Surg Case Rep 2018; 44:176-180. [PMID: 29524856 PMCID: PMC5928032 DOI: 10.1016/j.ijscr.2018.02.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 01/18/2018] [Accepted: 02/17/2018] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Gastrointestinal duplication cyst is a congenital rare disease that may occur in any region from mouth to anus. Among them, gastric duplication cysts are very rare. CASE REPORT Here we report A 23-year-old Japanese man who visited our hospital to evaluate an abdominal tumor. Abdominal computed tomography showed a well-circumscribed homogenous low-density mass measuring 6.2 × 6.0 cm between the pancreatic tail and the upper posterior wall on the gastric greater curvature, and the mass seemed to originate from the pancreatic tail. We found intraoperatively that the mass adhered to the stomach and pancreatic tail strongly, so we performed laparoscopic partial gastrectomy and spleen-preserving distal pancreatectomy. Pathological findings showed that the lining epithelium of the cystic mass consisted of the gastric foveolar epithelium with fundic glands. Furthermore, the pancreatic tissue of the pancreatic tail and the muscular layer of the cystic mass were intermingled. DISCUSSION GDCs are usually diagnosed at a younger age and in adults, they are very rare. Therefore, surgical resection is considered to be the best treatment due to the difficulty of diagnosis, and also that it mimics a pancreatic cystic tumor, and malignant transformation. Complete resection of the cyst is the ideal technique and laparoscopic surgery should be selected whenever possible. CONCLUSION We experienced a case of GDC continuous to both stomach and pancreatic tail. Laparoscopic surgery is safety and useful even if GDC is continuous with both the stomach and the pancreas.
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Affiliation(s)
- Hiromichi Kawaida
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Ayako Kimura
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Mitsuaki Watanabe
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Hidenori Akaike
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Naohiro Hosomura
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Yoshihiko Kawaguchi
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Hidetake Amemiya
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Makoto Sudo
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Hiroshi Kono
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Masanori Matsuda
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Hideki Fujii
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Daisuke Ichikawa
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Mitsuharu Fukasawa
- First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Japan.
| | - Ei Takahashi
- First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Japan.
| | - Katsuhiro Sano
- Department of Radiology, Faculty of Medicine, University of Yamanashi, Japan.
| | - Tomohiro Inoue
- Department of Human Pathology, Faculty of Medicine, University of Yamanashi, Japan.
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