Esophageal duplication cyst
Updates to Article Attributes
Oesophageal duplication cysts are a type of congenital foregut duplication cyst.
Epidemiology
Less common compared to other foregut duplication cysts. There may be an increased male predilection 5.
Clinical presentation
Patients are generally asymptomatic but may complain of dysphagia due to oesophageal compression. They typically present in childhood.
Pathology
They are a congenital malformation of the posterior primitive foregut and results from an aberration of the posterior division of the embryonic foregut at 3-4 weeks gestation. They are commonly lined by gastric epithelium. This ectopic gastric mucosa is prone to infection, perforation and haemorrhage.
Location
It mainly occurs in the thoracic oesophagus 4and are more common on the right particularly in the distal oesophagus.
Associations
- spina bifida
- oesophageal atresia
- other duplication cysts of the gut
Radiographic features
Plain radiograph
Well defined soft tissue density in close association with the oesophagus.
Fluoroscopy
On barium swallow, the cyst may cause extrinsic compression of the oesophagus.
CT
Well defined thick walled-walled structure (fluidwith internal fluid density) noted along the oesophagus.
MRI
- T1: low to intermediate signal intensity
- T2: high signal intensity
Treatment and prognosis
Surgical resection is the mainstay of management 8. Prognosis tends to be very good as recurrence is rare 8.
Complications
Recognised complications include carcinoma arising within the cyst 5. If gastric mucosa is present, peptic ulceration may occur. Very occasionally they may perforate, haemorrhage or erode into adjacent structures.
Differential diagnosis
For uncomplicated cysts consider:
- congenital cysts and malformations in the region
- cervical lymphadenopathy
- oesophageal malignancy
- pancreatic pseudocyst: for retroperitoneal bronchogenic cysts or for pancreatic pseudocysts that extend intrathoracically through the aortic or oesophageal hiatus
For complicated cysts (e.g. with haemorrhage/necrosis) the differential can be broader and can include:
- abscess(es)
- enlarged lymph nodes (especially centrally necrotic)
- pulmonary masses
- oesophageal malignancy
- haematoma
See also
-<p><strong>Oesophageal duplication cysts </strong>are a type of congenital <a href="/articles/foregut-duplication-cyst">foregut duplication cyst</a>.</p><h4>Epidemiology</h4><p>Less common compared to other <a href="/articles/foregut-duplication-cyst">foregut duplication cysts.</a> There may be an increased male predilection <sup>5</sup>.</p><h4>Clinical presentation</h4><p>Patients are generally asymptomatic but may complain of <a href="/articles/dysphagia">dysphagia</a> due to oesophageal compression. They typically present in childhood. </p><h4>Pathology</h4><p>They are a congenital malformation of the posterior primitive foregut and results from an aberration of the posterior division of the embryonic foregut at 3-4 weeks gestation. They are commonly lined by gastric epithelium. This ectopic gastric mucosa is prone to infection, perforation and haemorrhage.</p><h5>Location</h5><p>It mainly occurs in the thoracic oesophagus<sup> 4</sup>.</p><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>Well defined soft tissue density in close association with the oesophagus.</p><h5>Fluoroscopy</h5><p>On barium swallow, the cyst may cause extrinsic compression of the oesophagus.</p><h5>CT</h5><p>Well defined thick walled structure (fluid density) noted along the oesophagus.</p><h5>MRI</h5><ul>- +<p><strong>Oesophageal duplication cysts </strong>are a type of congenital <a href="/articles/foregut-duplication-cyst">foregut duplication cyst</a>.</p><h4>Epidemiology</h4><p>Less common compared to other <a href="/articles/foregut-duplication-cyst">foregut duplication cysts.</a> There may be an increased male predilection <sup>5</sup>.</p><h4>Clinical presentation</h4><p>Patients are generally asymptomatic but may complain of <a href="/articles/dysphagia">dysphagia</a> due to oesophageal compression. They typically present in childhood. </p><h4>Pathology</h4><p>They are a congenital malformation of the posterior primitive foregut and results from an aberration of the posterior division of the embryonic foregut at 3-4 weeks gestation. They are commonly lined by gastric epithelium. This ectopic gastric mucosa is prone to infection, perforation and haemorrhage.</p><h5>Location</h5><p>It mainly occurs in the thoracic oesophagus<sup> 4 </sup>and are more common on the right particularly in the distal oesophagus.</p><h5>Associations</h5><ul>
- +<li><a title="Spina bifida" href="/articles/spina-bifida">spina bifida</a></li>
- +<li><a title="Oesophageal atresia" href="/articles/oesophageal-atresia">oesophageal atresia</a></li>
- +<li>other duplication cysts of the gut</li>
- +</ul><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>Well defined soft tissue density in close association with the oesophagus.</p><h5>Fluoroscopy</h5><p>On barium swallow, the cyst may cause extrinsic compression of the oesophagus.</p><h5>CT</h5><p>Well defined thick-walled structure with internal fluid density noted along the oesophagus.</p><h5>MRI</h5><ul>
-</ul><h4>Treatment and prognosis</h4><p>Surgical resection is the mainstay of management <sup>8</sup>. Prognosis tends to be very good as recurrence is rare <sup>8</sup>.</p><h5>Complications</h5><p>Recognised complications include carcinoma arising within the cyst <sup>5</sup>.</p><h4>Differential diagnosis</h4><p>For uncomplicated cysts consider:</p><ul><li>congenital cysts and malformations in the region<ul>- +</ul><h4>Treatment and prognosis</h4><p>Surgical resection is the mainstay of management <sup>8</sup>. Prognosis tends to be very good as recurrence is rare <sup>8</sup>.</p><h5>Complications</h5><p>Recognised complications include carcinoma arising within the cyst <sup>5</sup>. If gastric mucosa is present, peptic ulceration may occur. Very occasionally they may perforate, haemorrhage or erode into adjacent structures.</p><h4>Differential diagnosis</h4><p>For uncomplicated cysts consider:</p><ul>
- +<li>congenital cysts and malformations in the region<ul>
- +<li><a title="Thyroglossal duct cyst" href="/articles/thyroglossal-duct-cyst">thyroglossal duct cyst</a></li>
- +<li><a title="Branchial cleft cysts" href="/articles/branchial-cleft-anomalies">branchial cleft cyst</a></li>
- +</ul>
- +</li>
- +<li>cervical lymphadenopathy</li>
- +<li><a title="Oesophageal malignancy" href="/articles/oesophageal-carcinoma-1">oesophageal malignancy</a></li>
-</ul>-</li></ul><p>For complicated cysts (e.g. with haemorrhage/necrosis) the differential can be broader and can include:</p><ul>- +</ul><p>For complicated cysts (e.g. with haemorrhage/necrosis) the differential can be broader and can include:</p><ul>
- +<li><a href="/articles/oesophageal-carcinoma-1">oesophageal malignancy</a></li>
Image 3 X-ray (Frontal) ( create )
Image 4 CT (C+ arterial phase) ( create )
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