Poster Session : PS 1047 ; Gastroenterology (Gastrointestinal Tract) ; Hematoma in Esophageal Duplication Cyst Masquerading Submucosal Tumor = Poster Session : PS 1047 ; Gastroenterology (Gastrointestinal Tract) ; Hematoma in Esophageal Duplication Cyst Masquerading Submucosal Tumor

다국어 초록 (Multilingual Abstract)

Esophageal duplication cysts account for a very small percentage of benign esophageal tumor that is usually diagnosed in childhood, but very rare cases remain asymptomatic until adolescence. They may be asymptomatic or present with complications like infection, bleeding, or mass effect. A 19-years-women visited our hospital presenting chest pain and dysphagia. Contrast enhanced computed tomography of the chest showed a heterogeneous density of mass in left lateral wall of distal thoracic esophagus. On endoscopic ultrasound, a heterogeneously echotextured lesion with anechoic components present and no vascular component in Doppler sonogram at intramural location in the lower esophagus was noted. In view of symptoms of dysphagia and possibility of esophageal submucosal tumor, surgical excision through posterolateral thoracotomy was performed. In gross fi nding, a mass measurred 4. 0 x 4. 0 x 2. 0 cm and formed cyst with hematoma formation in it. Histopathologically the cyst was lined by pseudostratifi ed ciliated columnar epithelium surrounded by inner circular and outer longitudinal smooth muscle layers without cartilage. So it was diagnosed as a complicated esophageal duplication cyst with hematoma formation. Esophageal duplication cyst represent rare benign tumor of congenital foregut anomalies. Up to 80% of these cysts are diagnosed in childhood, less than 7% remain asymptomatic until adolescence. Pain and dysphagia are the most common symptoms in adults. Complications may be infections, rupture or bleeding. Diagnosis is usually made by computed tomography and endoscopic ultrasound. The only defi nite treatment is surgical excision. Pathologically, the cyst is covered with nonkeratinizing squamous or ciliated columnar epithelium, and the cyst wall contains two layers of smooth muscle. These fi ndings, accompanied by a lack of cartilage in the cyst wall, can differentiate an esophageal duplication cyst from a bronchogenic cyst.