Esophageal duplication cyst with hemivertebrae: A case report and literature review
Yanfang Liu1, Ling Zhou, Shuixue Li
1Xinjiang Uygur Autonomous Region People's Hospital, Urumqi, Xinjiang, China.
Insights
Esophageal duplication cysts (EDCs) are rare congenital anomalies. This case highlights an infant with an EDC causing symptoms despite co-existing spinal abnormalities, emphasizing complete surgical resection for symptom resolution.
Area of Science:
- Pediatric Surgery
- Congenital Anomalies
- Gastrointestinal Surgery
Background:
- Esophageal duplication cysts (EDCs) are rare congenital anomalies.
- EDCs can be associated with spinal abnormalities, but EDC symptoms are rarely the primary presentation in such cases.
Observation:
- A 6-month-old infant presented with persistent pulmonary infection, dysphagia, and feeding intolerance.
- Imaging revealed a large mediastinal cystic mass compressing adjacent organs and trachea, with concurrent T3-T4 hemivertebrae.
- Surgical exploration confirmed the mediastinal mass, leading to complete resection via thoracotomy.
Findings:
- Pathophysiological examination confirmed the resected mass as an esophageal duplication cyst.
- The infant's symptoms resolved completely post-operatively.
- The co-existing hemivertebrae were asymptomatic and did not require intervention.
Implications:
- Noninvasive imaging may not always delineate the precise extent of EDCs.
- Surgical resection is curative for symptomatic EDCs, even in the presence of asymptomatic spinal anomalies.
- This case underscores the importance of considering EDCs as a cause of unexplained symptoms in infants, irrespective of concurrent spinal findings.
Background:
Esophageal duplication cysts (EDCs) are rare congenital anomalies that can be associated with symptomatic spinal abnormalities, but presentations due to EDC symptoms are rarely found in the presence of spinal abnormalities.
Case Summary:
A 6-month-old infant weighing approximately 5.0 kg presented with a 2-month pulmonary infection and more recent difficulty swallowing and nutritional intolerance that did not improve with medical treatment. Contrast-enhanced chest computed tomography showed a well-defined, mediastinal, homogeneous, low-density cystic mass of 11.9 × 5.5 × 5.1 cm, compressing the liver and bending the trachea forward. Hemivertebrae were present (T4 and T3). Diagnostic laparoscopy was performed, but was converted to open surgery. After ensuring that the cyst was not within the abdominal cavity, thoracotomy was performed, and the cyst was completely resected. Pathophysiological examination revealed an EDC. The patient recovered well, without symptoms 6 months later.
Conclusions:
Overall, noninvasive imaging and diagnostic procedures may not be sufficient to define the exact location of an EDC. Although hemivertebrae were present, they were asymptomatic and did not require treatment; only the EDC induced nonspecific symptoms that disappeared after surgery.
