Esophageal duplication cyst

Last revised by Dr Vitalii Rogalskyi on 16 Jun 2021

Esophageal 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 esophageal 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 hemorrhage.

It mainly occurs in the thoracic esophagus 4 and are more common on the right particularly in the distal esophagus.

Well defined soft tissue density in close association with the esophagus.

On barium swallow, the cyst may cause extrinsic compression of the esophagus.

Well defined thick-walled structure with internal fluid density noted along the esophagus.

  • T1: low to intermediate signal intensity
  • T2: high signal intensity

Surgical resection is the mainstay of management 8. Prognosis tends to be very good as recurrence is rare 8.

Recognized complications include carcinoma arising within the cyst 5. If gastric mucosa is present, peptic ulceration may occur. Very occasionally they may perforate, hemorrhage or erode into adjacent structures.

For uncomplicated cysts consider:

For complicated cysts (e.g. with hemorrhage/necrosis) the differential can be broader and can include:

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Cases and figures

  • Case 1
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  • Case 2
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  • Case 3: superior mediastinal mass
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  • Case 3
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