Adenocarcinoma arising from a gastric duplication cyst: a case report and literature review

Alimentary tract cystic duplication is a rare congenital anomaly predominantly affecting females, and diagnosed mostly in the early years of life. We present here a case of a 51-year-old man presenting with a 2-day history of melena. Gastroscopy showed fresh blood, as well as a mass lesion and cavity at the fundus. Biopsies of the mass edge reported the occurrence of moderately differentiated adenocarcinoma and mild chronic gastritis. Computed tomography imaging showed a 5.1×6.5 cm cystic mass in the gastric greater curvature. The patient received six cycles of epirubicin, capecitabine, and oxaliplatin, followed by uncomplicated total gastrectomy. Data from all 11 reports of similar cases were reviewed and pooled. The result shows male predominance and variable symptoms, as well as a wide age range (25-76 years) at presentation. The cysts are commonly located along the greater curvature and are unilocular. Surgery was the treatment in most cases. Alimentary tract cystic duplication is rare and may predispose to malignancy. Early diagnosis and prompt surgical intervention is important for the best outcome.