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cervical esophageal duplication cyst

Tuesday 24 May 2011

Cervical esophageal duplication cysts are rare congenital anomalies that can be successfully managed surgically. These anomalies are rare causes of upper airway obstruction.

Foregut duplication is commonly found in the posterior mediastinum. 10-20% of these anomalies are associated with oesophageal duplication. It can occur in all parts of oesophageal length.

Although duplication of cervical oesophagus has been previously reported, but a majority of them were found in thoracic oesophagus.

Infants with oesophageal duplication usually manifested by respiratory distress or asymptomatic thoracic mass, casually, detected in X-ray.

Although cervical oesophageal duplication cysts are rare, but they must be considered as one of the differential diagnoses of cervical mass with respiratory distress in infants.

Duplications of the esophagus are the second most common site of duplication of the alimentary tract.

Cervical esophageal duplication cysts occur in the upper one third of the esophagus and are the second rarest type of esophageal duplication cyst.

The location and size of the lesion determines the clinical presentation. These congenital anomalies can also be discovered as an incidental finding.

In 1711, Blasius reported the first case of esophageal duplication cyst [3]. The first reported case of a cervical esophageal duplication cyst was by Bishop and Koop in 1964. Arbona et al reviewed 50 000 autopsies and concluded that the incidence rate of these congenital anomalies was 1 in
8200.

A review of the literature documented 18 reported cases of cervical esophageal duplication cysts. Of symptomatic cases, about 50% present with respiratory distress in the first year of life.

Of the cases that reported sex, a male sex predilection (2:1) has been
observed.

Associations

- cervical vertebral defect and Horner syndrome (#15793745#)

See also

- esophageal duplication cyst

  • The esophageal duplication cysts are thought to arise from foregut budding errors during the third to sixth week of gestation.
  • During embryologic development, the laryngotracheal groove divides into the dorsal and ventral portions, which become the esophagus and respiratory tract, respectively.
  • An esophageal cyst forms when the secretory vacuoles during foregut luminal obliteration fail to coalesce. The timing of the budding error dictates the location of the cyst.
  • Early errors result in cysts being formed in the mediastinum such as cervical esophageal duplication cysts.

References

- Duplication of cervical oesophagus: a case report and review of literatures. Nazem M, Amouee AB, Eidy M, Khan IA, Javed HA. Afr J Paediatr Surg. 2010 Sep-Dec;7(3):203-5. PMID: #20859033# [Free]

- Cervical esophageal duplication cyst: case report and review of the literature. Nayan S, Nguyen LH, Nguyen VH, Daniel SJ, Emil S. J Pediatr Surg. 2010 Sep;45(9):e1-5. PMID: #20850608#

- Prenatal sonographic findings of an isolated cervical esophageal duplication cyst. Sherer DM, Timor-Tritsch IE, Dalloul M, Zinn H, Sokolovski M, Kheyman M, Yu S, Abulafia O. J Ultrasound Med. 2009 Mar;28(3):405-7. PMID: #19244082#

- Isolated cervical esophageal duplication: a rarity. Sharma KK, Ranka P, Meratiya S. J Pediatr Surg. 2005 Mar;40(3):591-2. PMID: #15793745#

- Duplication of the cervical esophagus: a case report and review of the literature. Wootton-Gorges SL, Eckel GM, Poulos ND, Kappler S, Milstein JM. Pediatr Radiol. 2002 Jul;32(7):533-5. PMID: #12107589#

- Antenatal identification of a cervical oesophageal duplication. McCullagh M, Bhuller AS, Pierro A, Spitz L. Pediatr Surg Int. 2000;16(3):204-5. PMID: #10786982#

- Esophageal duplication cyst with esophageal web and tracheoesophageal fistula. Snyder CL, Bickler SW, Gittes GK, Ramachandran V, Ashcraft KW. J Pediatr Surg. 1996 Jul;31(7):968-9. PMID: #8811570#

- Duplication of the cervical oesophagus in adults. Borcar J, Hughes CF. Aust N Z J Surg. 1988 Sep;58(9):746-8. PMID: #3250435#

- Cervical esophageal duplication cyst: MR imaging. Rhee RS, Ray CG 3rd, Kravetz MH, Langer B, Harris V, Grewe GM, Spigos DG. J Comput Assist Tomogr. 1988 Jul-Aug;12(4):693-5. PMID: #3392283#

- Duplication of the cervical esophagus. An unrecognized cause of respiratory distress in infants. Winslow RE, Dykstra G, Scholten DJ, Dean RE. Am Surg. 1984 Sep;50(9):506-8. PMID: #6476614#