A case of dysphagia due to an esophageal duplication cyst in a difficult anatomical site: A challenging situation for endoscopic treatment

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Introduction Esophageal duplication cyst may cause symptoms due to compression, rupture and inflammation of the esophagus and require intervention when being symptomatic. Case report We report the case of an 83-year-old patient with a five month history of dysphagia. Esophagogram showed a filling deficit below the UES and esophagoscopy revealed a polypoid projecting mass (Figure) immediately after the UES. The patient underwent an endoscopic ultrasound (EUS) to identify this polypoid mass which revealed characteristics of a clear submucosal formation located in the area of the 3rd ultrasound layer (Figure), with preservation of the integrity and sound structure of the other layers. After aspiration of the content a thick mucous amorphous material was drained (mucous cyst) that was negative for malignancy. Re-endoscopy was performed and the cyst was opened with a longitudinal fissure with a needle-knife sphincterotomy, with subsequent outflow of copious yellow-gray mucous contents and flattening of the cyst (Figure) [ 1 ] [ 2 ] [ 3 ] [ 4 ]. Conclusions Treatment for this condition is currently moving from surgery to endoscopic interventions. Small duplication cysts can be removed completely with a polypectomy loop or with an insulated tip knife safely and effectively. Publication History Article published online: 27 March 2025 © 2025. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

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