Diagnosis and treatment of specially cystic lesion located at the area of the left adrenal gland : 2 cases reports of adult gastric duplicated cyst / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate thedifferential diagnosis of specially cystic masses located at the area of the left adrenal gland,and to improve the understanding of the clinical symptoms and pathological features,diagnosis and treatment of gastric duplicated cyst.Methods A retrospective study,with literature review,of clinical characteristics and imaging findings of pathologically proved gastric duplicated cyst in 2 adults (2 males,28 years and 42 years)was conducted.Two patients presented no clinical manifestation.Abdominal ultrasonography and CT scan revealed a cystic lesion,in the area of the left adrenal gland,with a thickness wall,measuring 5 cm ×6 cm× 7 cm and 8 cm × 12 cm × 13 cm,attached to the greater curvature of the stomach.The lesion had septums,and the walls and septums could not be enhanced.Preoperative diagnosis of patients was misdiagnosed as a cyst of the left adrenal gland,with inflection or bleeding.Results Complete excision was performed by laparoscopic surgery in all cases.The lesion located in the area of left adrenal gland and no communication between the duplicated cyst and the lumen of stomach was detected.Postoperatively,the lesions were pathologically proved to be gastric duplicated cyst.There was no recurrence during the follow-up of 8 months and 2 years.Conclusions Preoperative definite diagnosis of adult gastric duplication cyst is very difficult.Ultrasonography and Computed Tomography are valuable imaging modality for locating the site and determining the nature of adult gastric duplicated cyst.Preoperative definite diagnosis could be made by EUS (endoscopic ultrasonography) and EUS-guided fine needle aspiration biopsy in gastric duplicated cyst.Although adult gastric duplicated cyst is an extremely rare disease entity,but this unusual developmental abnormality should be include in the differential diagnosis of cystic masses located the area of the left adrenal gland.Because of the possibility of malignancy of the cyst,laparoscopic excision is the first choice as the minimally invasive treatment.