Oesophageal duplication cysts are a type of congenital foregut duplication cyst.
Less common compared to other foregut duplication cysts. There may be an increased male predilection 5.
Patients are generally asymptomatic but may complain of dysphagia due to oesophageal compression. They typically present in childhood.
They are a congenital malformation of the posterior primitive foregut and results from an aberration of the posterior division of the embryonic foregut at 3-4 weeks gestation. They are commonly lined by gastric epithelium. This ectopic gastric mucosa is prone to infection, perforation and haemorrhage.
It mainly occurs in the thoracic oesophagus 4.
Well defined soft tissue density in close association with the oesophagus.
On barium swallow, the cyst may cause extrinsic compression of the oesophagus.
Well defined thick walled structure (fluid density) noted along the oesophagus.
- T1: low to intermediate signal intensity
- T2: high signal intensity
Treatment and prognosis
Surgical resection is the mainstay of management 8. Prognosis tends to be very good as recurrence is rare 8.
Recognised complications include carcinoma arising within the cyst 5.
For uncomplicated cysts consider:
- congenital cysts and malformations in the region
- pericardial cyst
- cystic hygroma/lymphangioma
- neurenteric cyst
- anterior or lateral meningocele
- oesophageal duplication cyst
- thyroid colloid cyst
- thymic cyst
- pancreatic pseudocyst: for retroperitoneal bronchogenic cysts or for pancreatic pseudocysts that extend intrathoracically through the aortic or oesophageal hiatus
For complicated cysts (e.g. with haemorrhage/necrosis) the differential can be broader and can include:
- enlarged lymph nodes (especially centrally necrotic)
- pulmonary masses
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- 2. Kuhlman JE, Fishman EK, Wang KP et-al. Esophageal duplication cyst: CT and transesophageal needle aspiration. AJR Am J Roentgenol. 1985;145 (3): 531-2. doi:10.2214/ajr.145.3.531 - Pubmed citation
- 3. Grainger & Allison's diagnostic radiology essentials. Churchill Livingstone. ISBN:0702034487. Read it at Google Books - Find it at Amazon
- 4. Zhang Z, Jin F, Wu H et-al. Double esophageal duplication cysts, with ectopic gastric mucosa: a case report. J Cardiothorac Surg. 2013;8 (1): 221. doi:10.1186/1749-8090-8-221 - Pubmed citation
- 5. Jacob R, Hawkes ND, Dallimore N et-al. Case report: Squamous carcinoma in an oesophageal foregut cyst. Br J Radiol. 2003;76 (905): 343-6. Pubmed citation
- 6. Wiechowska-Kozłowska A, Wunsch E, Majewski M et-al. Esophageal duplication cysts: endosonographic findings in asymptomatic patients. World J. Gastroenterol. 2012;18 (11): 1270-2. doi:10.3748/wjg.v18.i11.1270 - Free text at pubmed - Pubmed citation
- 7. Rangasami R, Chandrasekharan A, Archana L et-al. Case report: Antenatal MRI diagnosis of esophageal duplication cyst. Indian J Radiol Imaging. 2009;19 (1): 75-7. doi:10.4103/0971-3026.45350 - Free text at pubmed - Pubmed citation
- 8. Abu-Zaid A, Azzam A. Esophageal Duplication Cyst. (2014) New England Journal of Medicine. 11;371(24):e36.
- oesophageal dysmotility
- oesophageal tumours
- benign oesophageal neoplasms
- malignant oesophageal neoplasms
- gastro-oesophageal reflux disease
- oesophageal stricture