Esophageal Duplication Cyst -- A Guest Case in Robotic and Computer-Assisted Surgery From the University of Nebraska Medical Center

Chad Ringley, MD; Victor Bochkarev, MD; Dmitry Oleynikov, MDSeries Editors: Brant K. Oelschlager, MD; Carlos A. Pellegrini, MD


November 02, 2006

Cystic Masses of the Mediastinum

Many tumors can undergo cystic degeneration. Lesions, such as thymomas, Hodgkin's lymphoma, germ cell tumors (mature teratoma), mediastinal carcinomas, metastases to lymph nodes, and nerve root tumors -- especially if they undergo radiation therapy or chemotherapy -- may demonstrate mixed solid and cystic elements on computed tomographic (CT) or magnetic resonance imaging (MRI) exam. If degeneration is extensive, such tumors may be virtually indistinguishable from congenital cysts. Thymic cysts (congenital and acquired) represent 1% of all mediastinal masses.[18] Acquired thymic cysts may occur in patients after radiation therapy for Hodgkin's disease, in association with thymic tumors, and after thoracotomy. Other cystic lesions that can be found in the mediastinum include lymphangioma (0.7% to 4.5% of all mediastinal tumors), choriocarcinoma, cystic schwannoma, lateral thoracic meningocele, and pericardial cyst.[18] A mediastinal abscess or pancreatic pseudocyst can also appear as a fluid-containing mediastinal cystic mass.[19]

Which of the following studies is most likely to confirm the diagnosis of an esophageal duplication cyst: chest x-ray, upper gastrointestinal barium studies, CT scan, repeat esophagogastroscopy, esophagogastroscopy with endoscopic ultrasound (EUS), MRI, positron emission tomography (PET), or radionuclide scanning?

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