Gastric Duplication Cyst Removed by Endoscopic Submucosal Dissection

Jung Seop Eom; Gwang Ha Kim; Geun Am Song; Dong Hoon Baek; Kwang Duck Ryu; Kyung Nam Lee; Do Youn Park

doi:10.4166/kjg.2011.58.6.346

Journal List > Korean J Gastroenterol > v.58(6) > 1006892

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Eom, Kim, Song, Baek, Ryu, Lee, and Park: Gastric Duplication Cyst Removed by Endoscopic Submucosal Dissection

Case Report

Korean J Gastroenterol 2011;58(6):346-349.

Published online: 4 October 2011

DOI: https://doi.org/10.4166/kjg.2011.58.6.346

Gastric Duplication Cyst Removed by Endoscopic Submucosal Dissection

Jung Seop Eom, Gwang Ha Kim, Geun Am Song, Dong Hoon Baek, Kwang Duck Ryu, Kyung Nam Lee, Do Youn Park¹

Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea

¹Department of Pathology, Pusan National University School of Medicine, Busan, Korea

Correspondence to: Gwang Ha Kim, Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, 1-10, Ami-dong, Seo-gu, Busan 602-739, Korea. Tel: +82-51-240-7869, Fax: +82-51-244-8180, E-mail: doc0224@pusan.ac.kr

Received 25 July 2011 Accepted 7 August 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Duplication cysts are uncommon congenital malformations that may occur anywhere throughout the alimentary tract. The stomach is an extremely rare site of occurrence. Here, we report a case of gastric duplication cyst initially presenting with a gastric submucosal tumor. A 28-year-old man complained of dyspepsia lasting 1 year and upper endoscopy revealed an ellipsoid submucosal tumor at the greater curvature of the antrum. We intended to use the injection-and-cut technique: however, after saline injection, the lesion was dented and impossible to grasp with a snare. Therefore, we decided to perform endoscopic submucosal dissection and removed the tumor without complication. Histopathology revealed a 0.6×0.6 cm-sized duplication cyst, and there has been no recurrence in 2 years.

Keywords: Stomach, Duplication cyst, Endoscopic resection

References

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Fig. 1.

Endoscopic submucosal dissection of gastric duplication cyst. (A) A submucosal tumor at the greater curvature of the antrum. (B) EUS shows an anechoic homogenous, oval lesion originating from the submucosal layer of the stomach wall; the wall of the cystic lesion is shown as a five-layer structure. (C) After injecting saline with indigo carmine into the submucosa beneath the lesion, the lesion becomes flattened. (D) A complete circumference incision is made using an insulation-tipped knife. (E) The lesion is completely removed. (F) The inner surface of the resected specimen.

Fig. 2.

Histopathologic features of the resected specimen. (A) Pathologic examination revealed that the submucosal mass was a cystic lesion (H&E, ×20). (B) The cystic space was lined by columnar epithelial mucosa and had its own muscle layer (H&E, ×40). (C) In the cystic wall, ectopic pancreatic tissue was present, consisting of acinar and ductal structures (H&E, ×40). (D) The mucosa consisted of enteric- type columnnar epithelium (H&E, ×40).

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