Retroperitoneal enteric duplication cyst.

Area of Science:

• Gastroenterology
• Surgical Pathology
• Pediatric Surgery

Background:

• Enteric duplication cysts (EDCs) are congenital anomalies typically found along the alimentary tract, most commonly the small bowel and esophagus.
• Retroperitoneal EDCs are exceedingly rare, with limited documented cases in medical literature.
• Early diagnosis and surgical management are crucial for favorable outcomes in patients with EDCs.

Observation:

• A 19-year-old female presented with acute abdominal pain, leading to the discovery of a large retroperitoneal cystic mass.
• Surgical exploration revealed a cystic tumor measuring 13.0 x 8.0 x 3.5 cm, lacking apparent communication with the gastrointestinal tract.
• Pathologic examination confirmed the diagnosis of an enteric duplication cyst.

Findings:

• This case represents the seventh reported instance of a retroperitoneal EDC globally and the first in an adolescent with distinct clinical and histopathologic features.
• The cyst's retroperitoneal location and lack of direct connection to the alimentary tract presented diagnostic challenges.
• Histopathological analysis revealed unique characteristics differentiating it from previously reported retroperitoneal EDCs.

Implications:

• This case expands the known spectrum of EDC presentations and underscores the importance of considering EDCs in the differential diagnosis of retroperitoneal masses.
• Further research into the embryogenesis and diverse presentations of EDCs may improve diagnostic accuracy and treatment strategies.
• Highlights the need for comprehensive diagnostic workups for abdominal pain in adolescents, even with seemingly straightforward presentations.