A Case of Duplication of the Alimentary Tract astride both the Esophagus and the Stomach at Cardia Suggested the Primitive Foregut Origin

Chihiro Tanaka, Naoki Yokoo, Yasuhito Kitakado, Takashi Shiroko, Takami Fukui, Takahiro Yoshida, Katsuaki Ura, Shinya Hamasu and Kiyohisa Okamoto^*

Department of Surgery, Department of Pathology^*, Takayama Red Cross Hospital

A 35-year-old woman admitted to our hospital was suspected of having a submcosal tumor in the posterior wall of the cardia after upper gastrointestinal radiography in a medical checkup. Abdominal ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) showed a unilocular cyst 5 cm in diameter adjacent to the cardia. She was preoperatively diagnosed with gastric duplication bsaed on endoscopic ultrasonography and ^99mTc scintigraphy. Operative findings at laparotomy showed the tumor astride both the esophagus and stomach, sharing a common wall at 2×1.5cm. Tumor enuclation was conducted, based on a diagnosis of gastric duplication without malignancy in the rapid intraoperative frozen section diagnosis. The postoperative course was uneventful. CEA and CA19-9 in cyst fluid were quite high, but cytology of the fluid was in Class I. Histopathologically, mimic mucosa to stomach, ciliated columnar epithelium, and smooth musclar layer were observed in the inner wall of the cyst. These findings suggest the cyst arose from the primitive foregut.

Key words
alimentary tract duplication, ciliated columnar epithelium, foregut

Reprint requests
Chihiro Tanaka Department of Surgery, Takayama Red Cross Hospital 3-11 Tenman-cho, Takayama, 506-0025 JAPAN

Accepted
May 23, 2001

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