Enteric Duplication Cyst:
View cases of enteric duplication cyst
Clinical:
Enteric cysts (or enterogenous cysts) are congenital anomalies of the developing foregut and include esophageal duplication cysts and neurenteric cysts. The wall of an esophageal duplication cyst contains alimentary epithelium and 50-60% contain gastric mucosa or pancreatic tissue (digestive secretions may precipitate cyst hemorrhage or rupture). The wall of the cyst is characterized by two well developed smooth muscle layers and a myenteric plexus. The cyst are almost exclusively found within the esophageal wall or adherent to the esophagus- typically the distal right aspect. About 12% of patients with esophageal duplication cysts have associated congenital abnormalities- most commonly related to the GI tract.A neurenteric cyst is a term used to describe an enteric cyst associated with vertebral or neural anomalies secondary to failure of the foregut to lose its connection to the notocord. Intravertebral extension of the foregut can disrupt vertebral body developementr and induce a sagittal cleft or more severe vertebral abnormality. Because of the cephalic growth of the notocord and caudal growth of the foregut, the associated vertebral defects are typically superior to the mediastinal cyst. They frequently contain both neural and enteric tissue, including gastric mucosa. A fibrous tract attaching the cyst to the spine may be seen. About 90% of neurenteric cysts occur in the posterior mediastinum, usually superior to the carina, on the right, and separate from the esophagus. Associated vertebral abnroamlities are found in 50% of cases (scoliosis, anterior spina bifida, hemivertebrae, butterfly vertebrae).
X-ray:
Enteric cysts are sharply defined, rounded, soft tissue masses typically located in the middle or posterior mediastinum. The cyst wall is typically thicker than that associated with a bronchogenic cyst. The density of the contents of the cyst vary with their composition.REFERENCES:
(1) Chest 1997; Strollo DC, et al. Primary mediastinal tumors. Part II: Tumors of the middle and posterior mediastinum. 112:1344-57
