Esophageal duplication cyst

Changed by Matt Andrews, 11 Mar 2015

Back to revision history

Updates to Article Attributes

Body was changed:

Show markup changes

Oesophageal duplication cysts are a type of congenital duplication cyst.

Epidemiology

Incidence

Less common compared to other foregut duplication cysts. There may be an increased male predilection ⁵.

Pathology

They are a congenital malformation of the posterior primitive foregut and results from aberration of the posterior division of the embryonic foregut at 3-4 wk gestation. They are commonly lined by gastric epithelium. This ectopic gastric mucosa is prone to infection, perforation and haemorrhage.

Location

It mainly occurs within the thoracic oesophagus⁴.

Clinical presentation

They typically present in childhood.

generally asymptomatic or
~~dyphagia~~dysphagia due to esophageal compression

Radiographic features

Plain film

Well defined soft tissue density in close association with the esophagus

Barium swallow

Cyst may cause an extrinsic compression

CT

Well defined thick walled structure (fluid density) noted along the esophagus

MRI

T1: low to intermediate signal intensity
T2: high signal intensity

Complications

Recognised complications include

carcinoma arising within the cyst ⁵

Differential diagnosis

For uncomplicated cysts consider

congenital cysts and malformations in the region
- pericardial cyst
- cystic hygroma / lymphangioma
- neurenteric cyst
- anterior or lateral meningocoele
- oesophageal duplication cyst
- thyroid colloid cyst
- thymic cyst
- pancreatic pseudocyst (for retroperitoneal bronchogenic cysts or for pancreatic pseudocysts that extend intra thoracically through the aortic hiatus 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
haematoma

{"current_user":null,"inclusions":[{"imageId":8308841,"studyId":31727,"caseSlug":"oesophageal-duplication-cyst-1","caption":"Case 1","thumbnail":"https://prod-images-static.radiopaedia.org/images/8308841/5cee52b6f6d73c6e2ea441f8be8ea8_big_gallery.jpg","isStack":true,"diagnosticCertainty":"probable"},{"imageId":37019853,"studyId":66326,"caseSlug":"oesophageal-duplication-cyst-3","caption":"Case 2","thumbnail":"https://prod-images-static.radiopaedia.org/images/37019853/2e2de5b0f75e0bc6cc213e238bf449_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":51910948,"studyId":84190,"caseSlug":"superior-mediastinal-mass-due-to-oesophageal-duplication-cyst","caption":"Case 3: superior mediastinal mass","thumbnail":"https://prod-images-static.radiopaedia.org/images/51910948/9e022d2a7b5754a6390d8907c04e5381a9ec96a4158345e42ec9eccc642e8472_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":51910950,"studyId":84191,"caseSlug":"superior-mediastinal-mass-due-to-oesophageal-duplication-cyst","caption":"Case 3","thumbnail":"https://prod-images-static.radiopaedia.org/images/51910950/3426f7b5c34405552439e8c3012a6077ecc913a32f2df3482e8e0982f4fec886_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":60495376,"studyId":129866,"caseSlug":"esophageal-duplication-cyst-4","caption":"Case 4","thumbnail":"https://prod-images-static.radiopaedia.org/images/60495376/4b78e1a2ebddfedc679f7a60c136eff1163829dcc247664f93d34128704f6515_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":54848330,"studyId":105407,"caseSlug":"foregut-duplication-cyst-with-vertebral-anomalies","caption":"5. Foregut duplication cyst with vertebral anomalies","thumbnail":"https://prod-images-static.radiopaedia.org/images/54848330/fa16d75f5c2caacf3ef16949be1e1e793bdad75a2f3ab5e8c67465fac634c2d5_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated"}],"ddx_inclusions":[],"lang":"us"}