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 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 within 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
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 meningocoele
- 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
- oesophageal dysmotility
- oesophageal tumours
- benign oesophageal neoplasms
- malignant oesophageal neoplasms
- gastro-oesophageal reflux disease
- oesophageal stricture
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