Benign Enterogenous Cyst of the Pancreas

James Majeski, MD, PhD, Department of Surgery, East Cooper Hospital, Mt. Pleasant, SC; Joseph Harmon, MD, Department of Pathology, Roper Hospital, Charleston, SC

South Med J. 2000;93(3) 

In This Article

Abstract and Introduction

A 26-year-old woman was evaluated for a mass found by computed tomography (CT). Radiographically, the mass resembled a pancreatic cystadenoma. The patient had had left upper quadrant abdominal pain for several years and low grade fevers and indigestion for 5 months. At surgery, a unilocular cystic mass was found anteriorly and caudally to the tail of the pancreas in the lesser sac. The cystic structure was connected to the pancreas by a tubular structure, which was suture ligated and divided. A review of the literature revealed this cyst to be the fifth reported case of enterogenous cyst of the pancreas. The case is unique, differing from previous reports in that ciliated respiratory epithelium, transitional epithelium, gastric mucosa, a bilayered smooth muscle wall, and a serosal surface were present in the cyst wall.

Enterogenous cysts, enterocystomas, and duplications of the alimentary canal are a group of congenital abnormalities characterized by cystic or tubular formations connected with or adherent to any segment of the alimentary canal. These cysts are not uncommon in the pediatric age group but are rarely found in adults. They have been reported to occur in almost every portion of the gastrointestinal tract.[1] Duplication cysts in the mediastinum frequently contain ciliated epithelium, which is rarely found in the remainder of the gastrointestinal tract. In contrast, abdominal enterogenous cysts usually contain gastrointestinal epithelium and smooth muscle. Most cystic lesions of the pancreas are inflammatory pseudocysts, but approximately 10% are cystic neoplasms.[2] We report a case of enterogenous cyst of probable foregut origin that appeared clinically as a pancreatic cystic neoplasm.

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