Case Report

Esophageal Duplication Cyst Presenting with Dysphagia in a Middle-Aged Male: A Case Report

Abstract

Esophageal duplication cysts (EDCs) are rare congenital foregut anomalies often presenting with nonspecific gastrointestinal (GI) symptoms in childhood. Diagnosis requires a high index of suspicion and comprehensive work-up. We report a 56-yearold male with type 2 diabetes mellitus and benign prostatic hyperplasia. He presented with a one-month history of intermittent, burning epigastric pain exacerbated by eating and accompanied by nausea. Physical examination revealed mild epigastric tenderness. Upper GI endoscopy showed a bulging lesion in the lower esophagus, a large cardia polyp, a small gastric body polyp, and antral erythema. Endoscopic ultrasound (EUS) identified a well-defined, homogeneous, round lesion (33 × 20 mm)
Esophageal duplication cysts (EDCs) are rare congenital foregut anomalies often presenting with nonspecific gastrointestinal (GI) symptoms in childhood. Diagnosis requires a high index of suspicion and comprehensive work-up. We report a 56-yearold male with type 2 diabetes mellitus and benign prostatic hyperplasia. He presented with a one-month history of intermittent, burning epigastric pain exacerbated by eating and accompanied by nausea. Physical examination revealed mild epigastric tenderness. Upper GI endoscopy showed a bulging lesion in the lower esophagus, a large cardia polyp, a small gastric body polyp, and antral erythema. Endoscopic ultrasound (EUS) identified a well-defined, homogeneous, round lesion (33 × 20 mm)
demonstrating acoustic enhancement in the lower esophagus. Contrast-enhanced abdominopelvic computed tomography (CT) revealed an intraluminal, non-enhancing lesion (25 × 26 mm) at the lower esophageal sphincter (LES), suggestive of a duplication cyst. Thoracic imaging showed no abnormalities. Due to persistent symptoms, the patient underwent successful video-assisted thoracoscopic surgery without complications; no recurrences occurred during follow-up. EDCs should be considered in the differential diagnosis of submucosal or intraluminal esophageal lesions, even in adults despite their rarity. EUS yields high accuracy in characterizing these lesions. Thoraco-abdominal CT scans delineate relationships to surrounding structures. For symptomatic lesions, video-assisted thoracoscopic surgery demonstrates a successful outcome with low complication rates.

[1] Cook IJ, Kahrilas PJ. AGA technical review on management of oropharyngeal dysphagia. Gastroenterology. 1999
Feb;116(2):455-78. https://doi.org/10.1016/S0016- 5085(99)70144-7
[2] Nelms CD, White R, Matthews BD, Ballinger WE Jr, Sing RF, Heniford BT. Thoracoabdominal esophageal duplication
cyst. J Am Coll Surg. 2002 May;194(5):674-5. https://doi.org/10.1016/S1072-7515(02)01164-X
[3] Sonthalia N, Jain SS, Surude RG, Mohite AR, Rathi PM. Congenital Esophageal Duplication Cyst: A Rare Cause of
Dysphagia in an Adult. Gastroenterol Res. 2016 Oct;9(4-5):79- 82. https://doi.org/10.14740/gr711w
[4] Kolomainen D, Hurley PR, Ebbs SR. Esophageal duplication cyst: case report and review of the literature. Dis Esophagus. 1998 Jul;11(1):62-5. https://doi.org/10.1093/dote/11.1.62
[5] Chan M, Zavala SR. Esophageal Cyst. StatPearls. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
[6] Bagheri R, Asnaashari AM, Afghani R. Esophageal duplication cyst. Asian Cardiovasc Thorac Ann. 2015 Mar;23(3):332-4. https://doi.org/10.1177/0218492314530977
[7] Wahi JE, Safdie FM. Esophageal duplication cysts: a clinical practice review. Mediastinum. 2023;7:1. https://doi.
org/10.21037/med-22-33
[8] Gandhi D, Garg T, Shah J, Sawhney H, Crowder BJ, Nagar A. Gastrointestinal duplication cysts: what a radiologist needs to know. Abdom Radiol (NY). 2022 Jan;47(1):13-27. https://doi.org/10.1007/s00261-021-03239-w
[9] Lee N, Sabharwal S, Tee D, Dhatrak D, Ruszkiewicz A. Spontaneous self-expulsion of an oesophageal duplication
cyst. JGH Open. 2023 Jun;7(6):453-5. https://doi.org/10.1002/jgh3.12912
[10] Gonzalez-Urquijo M, Hinojosa-Gonzalez DE, Padilla-Armendariz DP, Saldaña-Rodriguez JA, Leyva-Alvizo A, Rodarte-Shade M, et al. Esophageal Duplication Cysts in 97 Adult Patients: A Systematic Review. World J Surg. 2022 Jan;46(1):154-62. https://doi.org/10.1007/s00268-021-06325-8
[11] Watanobe I, Ito Y, Akimoto E, Sekine Y, Haruyama Y, Amemiya K, et al. Laparoscopic resection of an intra-abdominal
esophageal duplication cyst: a case report and literature review. Case Rep Surg. 2015;2015:940768. https://doi.
org/10.1155/2015/940768
[12] Cuch B, Nachulewicz P, Wieczorek AP, Wozniak M, Pac- Kozuchowska E. Esophageal Duplication Cyst Treated
Thoracoscopically During the Neonatal Period: Clinical Case Report. Medicine (Baltimore). 2015 Dec;94(49):e2270.
https://doi.org/10.1097/MD.0000000000002270
[13] Singh S, Lal P, Sikora SS, Datta NR. Squamous cell carcinoma arising from a congenital duplication cyst of the esophagus in a young adult. Dis Esophagus. 2001;14(3-4):258-61. https://doi.org/10.1046/j.1442-2050.2001.00204.x
[14] Dai ZJ, Kang HF, Lin S, Bai MH, Ma L, Min WL, et al. Esophageal cancer with esophageal duplication cyst. Ann
Thorac Surg. 2013 Jul;96(1):e15-6. https://doi.org/10.1016/j. athoracsur.2013.01.019
[15] Kawashima S, Segawa O, Kimura S, Tsuchiya M, Henmi N, Hasegawa H, et al. A case of cervical esophageal duplication cyst in a newborn infant. Surg Case Rep. 2016 Dec;2(1):30. https://doi.org/10.1186/s40792-016-0157-2
[16] Endara SA, Pinto JR, Torres GA, Arias PA, Ponton MP, Molina GA. Severe dysphagia due to an esophageal duplication cyst in sixth decade, unusual presentation of a rare pathology. J Cardiothorac Surg. 2023 Jun 27;18(1):238. https://doi.
org/10.1186/s13019-023-02308-z
[17] Oyama S, Tanaka K, Moriyama M, Nonaka T, Tominaga T, Sawai T, et al. Laparoscopic resection of an intra-abdominal esophageal duplication cyst in the ileum: a case report. Surg Case Rep. 2022 Nov 17;8(1):219. https://doi.org/10.1186/s40792-022-01576-6
[18] Darwish B, Izzat MB. Video-assisted thoracoscopic excision of esophageal duplication cyst in an adult. Clin Case Rep. 2019 Nov;7(11):2140-2. https://doi.org/10.1002/ccr3.2457
[19] Diehl DL, Cheruvattath R, Facktor MA, Go BD. Infection after endoscopic ultrasound-guided aspiration of mediastinal cysts. Interact Cardiovasc Thorac Surg. 2010 Feb;10(2):338-40. https://doi.org/10.1510/icvts.2009.217067
[20] Bhatia V, Tajika M, Rastogi A. Upper gastrointestinal submucosal lesions--clinical and endosonographic
evaluation and management. Trop Gastroenterol. 2010 Jan- Mar;31(1):5-29.
[21] Eloubeidi MA, Cohn M, Cerfolio RJ, Chhieng DC, Jhala N, Jhala D, et al. Endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of foregut duplication cysts: the value of demonstrating detached ciliary tufts in cyst fluid. Cancer. 2004 Aug 25;102(4):253-8. https://doi.org/10.1002/cncr.20369
[22] Liu R, Adler DG. Duplication cysts: Diagnosis, management, and the role of endoscopic ultrasound. Endosc Ultrasound. 2014 Jul;3(3):152-60. https://doi.org/10.4103/2303-9027.138783
[23] Versleijen MW, Drenth JP, Nagengast FM. A case of esophageal duplication cyst with a 13-year follow-up
period. Endoscopy. 2005 Sep;37(9):870-2. https://doi.org/10.1055/s-2005-870219
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IssueVol 10 No 4 (2025): July-August QRcode
SectionCase Report(s)
DOI https://doi.org/10.18502/crcp.v10i4.21113
Keywords
Esophageal duplication cyst Dysphagia Intraluminal esophageal lesion Submucosal mass
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How to Cite
1.
Ghanipoor M, Evazi E, Basham A, Hadavand Khani A, Hashemi SM, Moosavy SH. Esophageal Duplication Cyst Presenting with Dysphagia in a Middle-Aged Male: A Case Report. CRCP. 2026;10(4):185-190.