Adenocarcinoma in a Non-communicating Cecal Duplication Cyst: An extremely rare case
Code: G-1049
Authors: Ehsan Hassanzadeh Haddad ℗, Ehsan Soltani, Ali Javidi Dasht Bayaz ©, Azadeh Jabbari Nooghabi, Tayyebeh Nazeran
Schedule: Friday 2023-12-08 10:30 on Unit Panel B
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Abstract:
Abstract
Duplication Cysts (DC) are congenital anomalies that occur during embryonic development. They can be communicating or non-communicating. The most common place is ileal. Although most DCs are benign and asymptomatic, they can rarely become malignant which adds an additional layer of complexity to the diagnosis and treatment process and is extremely rare. Malignancies inside DCs especially in non-communicating DCs which is observed in this case are extremely rare among English literature review. In this paper we present a non-communicating colon DC with adenocarcinoma which is extremely rare. A 53 year-old woman was referred to our surgical oncology department because of abdominal pain and feeling a fullness and a mass like lesion in her right abdomen. In her abdominal physical examination a large mass was palpated in right abdomen region. Lab tests including tumor markers (Alpha FPr, CA 19-9, CA 125, CEA) were within normal range. Chest CT sacn was normal. She had a cystic lesion 120 mm in diameter locating posterolateral to cecum and ascending colon in abdominal CT scan, with a 19 mm solid nodule in its periphery. The cyst didn’t have any connection with gastrointestinal (GI) tract. The differential diagnosis list includes mesenteric mesothelial cyst or hydatid cyst or ovarian tumor or duplication cyst therefor an explorative laparotomy was decided for diagnosis and treatment. While surgery, a huge cystic lesion was observed posterior to ascending colon. Grossly it was similar to intestine and located in ascending mesocolon. It had a smooth surface there wasn’t any connection find between the cyst and any other viscera. An enblock resection of the cystic mass with adjacent mesentery was performed. Histologic evaluation revealed that, it was an enteral duplication cyst full of cloudy liquid with a mucinous adenocarcinoma in the cyst wall nodule and out of four lymph nodes dissected in the specimen none of them was involved by the tumor cells (T1N0). We conclude that such as other colon cancers, enblock surgical resection remains the mainstay of treatment and adjuvant therapies and long-term surveillance is similar to colon cancer.
Keywords
Adenocarcinoma, Duplication cyst, Cecal duplication
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