Foregut duplication cyst of the stomach with pseudostratified columnar ciliated epithelium masquerading as leiomyoma.

摘要

Foregut duplication cyst of the stomach with pseudostratified columnar ciliated epithelium is extremely rare. However the documented cases of foregut duplication cyst are even rarer to find. Because of the highly variable clinical presentation of the foregut duplication cyst, they are usually diagnosed incidentally and intraoperatively in adults. We report a case of foregut duplication cyst of stomach in 42 year old male ,who presented with pain in the left lumbar region. Radiological features were suggestive of leiomyoma. Intraoperatively cyst arisingfrom the lesser curvature of the stomach was identified. Microscopic examination of the cyst wall revealed pseudostratified ciliated columnar epithelial lining and smooth muscle bundles in the wall. Introduction Foregut duplication cysts are rare but well documented. Even more exceptional are those occurring in the stomach 1 . These malformations are believed to be congenital and are formed before differentiation of the lining epithelium and, therefore, are named for the organs with which they are associated 2 . They are known to be the cause of a variety of symptoms, some of which may not present until later childhood, or even beyond. As a result their diagnosis in adults is usually delayed because of the non-specific symptoms. Morbidity is associated with complicated and infected foregut duplications and their resection can be a surgical challenge. In majority of the reported cases, the diagnosis is established during surgical exploration 3 .We herin report a case of foregut duplication cyst arising from te stomach in a 42 year old male which clinically and radiologically mimicked leiomyoma. Case Report A 42 year old male presented to the hospital with pain in the left lumbar region. His past medical history were unremarkable. Abdominal examination and routine laboratory tests were normal. Upper GI Endoscopy revealed an extrinsic compression at lower end of esophagus without any mucosal abnormalities. Abdominal Computed tomography revealed a 4.5 to 5.2cm sized well defined soft tissue density, with mild contrast enhancement, situated adjacent to anterior aspect of gastrointestinal junction and cardia of the stomach(figure 1.).Radiologically it was diagnosed as gastric leiomyoma .