Abstract
BackgroundGastric duplication cysts are rare congenital abnormalities, and malignant transformation of these duplications is also thought to be rare.Case presentationDuring a routine health checkup, a 28-year-old man underwent abdominal sonography followed by computed tomography (CT) with contrast agent, which revealed a cystic lesion with no enhancement. Laparoscopic surgery showed a 10 × 10 cm cyst adhering to the gastric corpus. However, attempts to remove the lesion en bloc were unsuccessful, and the ruptured cyst had contaminated the peritoneal cavity. Gastric duplication was diagnosed from microscopic examination of the cyst. Seven months later, the patient suffered a progressive increase in ascites, and repeated cytological analysis showed small nests of adenocarcinoma cells, with primary lesion unknown. Diagnostic laparoscopy showed multiple white nodules scattered over the surface of the liver, greater omentum, and peritoneum. Biopsy of the omental nodules confirmed adenocarcinoma, while carcinomatosis was diagnosed in the peritoneum.ConclusionsClinical presentation and chronological developments indicated that the malignancy probably originated from the gastric duplication cyst. This case highlights the importance of accurate preoperative diagnosis and optimal surgical management for gastric duplication as well as considering the potential existence of malignant transformation during surgical evaluation of adult patients with gastric duplication cysts.
Highlights
Gastric duplication cysts are rare congenital abnormalities, and malignant transformation of these duplications is thought to be rare.Case presentation: During a routine health checkup, a 28-year-old man underwent abdominal sonography followed by computed tomography (CT) with contrast agent, which revealed a cystic lesion with no enhancement
This case highlights the importance of accurate preoperative diagnosis and optimal surgical management for gastric duplication as well as considering the potential existence of malignant transformation during surgical evaluation of adult patients with gastric duplication cysts
Gastrointestinal duplications are mostly diagnosed during the first year of life [2], occasionally, gastric duplication cysts have been detected during health screening in adults, as was observed in the present study and that by Zheng et al [2]
Summary
We report a case of a gastric duplication cyst and peritoneal metastatic adenocarcinoma in a young adult man. The malignancy probably developed from the gastric duplication cyst, as indicated by the clinical presentation and chronological developments. We recommend that the possibility of malignant transformation be considered during surgical evaluation of adult patients with gastrointestinal duplication cysts. Consent Written informed consent was obtained from the patient for publication of this Case report and any accompanying images. Competing interests The authors declare that they have no competing interest. All authors read and approved the final manuscript. Author details 1Gastroenterology Department, Beijing Shijitan Hospital, Capital Medical University, No.. Author details 1Gastroenterology Department, Beijing Shijitan Hospital, Capital Medical University, No. Tieyi road, Haidian, Beijing 100038, People’s Republic of China. 2Pathology Department, Beijing Shijitan Hospital, Capital Medical University, No. Tieyi road, Beijing, Haidian 100038, People’s Republic of China
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