Foregut duplication cyst with vertebral anomalies

Tubular cystic lesion in the posterior mediastinum extending craniocaudally from subcarinal region down across the left hemidiaphragm through oesophageal hiatus up to the upper abdomen along the entire length of oesophagus and stomach. It is displacing and causing compression of carina. It is measuring approximately 166measures166 x 62 x 81mm. No grossenteric communication with duodenum and jejunum is identified. No evidence of oesophageal atresia. 

Associated failure of formation of vertebral anomalies including hemivertebra and butterfly vertebra of upper dorsal spine is also noted.

Foregut duplication cysts are congenital malformations of primitive foregut due to abnormal division of the primitive foregut induring early intrauterine life.

It is classified into three groups: 1.

• bronchogenic cyst, 2.

• enteric cyst,

• neurenteric cyst

Enteric cysts are typically closely related to the gastrointestinal tract and 3may contain one or two muscle layers. neuroentericThe cyst may lie within the musulcaris propria which splits around the lesion. Contraction is sometimes observed on ultrasound. The less common tubular cysts may communicate with the gut lumen. Vertebral anomalies occur infrequently.

ItBiopsy carries a significant risk of infection and is difficultusually avoided. Symptomatic lesions are excised and histology is characteristic. Ectopic elements may be present including gastric mucosa or pancreatic tissue which can give rise to distinguishulceration, haemorrhage or perforation. Malignancy is rare.

Uncomplicated bronchogenic cysts are thin-walled and oesophageal duplicationtypically parabronchial. Neurenteric cysts on imaging. however, enteric duplication cystspresent with neurological features due to their intraspinal location and spinal neuroenteric cysts can readily be distinguished on CT myelogram. In our case, a pathologically proven oesophageal duplication cyst washave associated with vertebral anomalies.