Abstract：
Gastric duplication cysts are rare congenital malformation with a potential neoplastic progression and they may represent a challenge in differential diagnosis with exophytic pancreatic cyst neoplasm. We describe a case of a 38-year old man, complaining of recurrent epigastric pain due to a large abdominal mass, referred to our Hospital for EUS evaluation. Differential diagnosis was between gastric duplication cyst and exophytic pancreatic cyst because of FNA pointed out amylase 1280 UI/L and CEA 593.33 ng/mL. Despite antibiotic prophylaxis, an overinfection of the lesion occurred after the FNA, likely due to the technical failure to drain the cyst completely. Afterwards, the patient was referred to surgery and the pathologist confirmed the diagnosis of gastric duplication cyst. In this setting, EUS procedure has gained a leading play, complementary to traditional imaging tests, although its role has been not yet standardized in the reported literature. Here, we describe and discuss our demanding case, and we propose an algorithm to simplify and standardize the diagnostic workup.
摘要：
胃重复囊肿是罕见的先天性畸形，具有潜在的肿瘤进展，它们可能是外生性胰腺囊肿肿瘤的鉴别诊断挑战。我们描述了一个38岁男子的案例，抱怨由于腹部大肿块引起的复发性上腹痛，转诊至我们医院接受EUS评估。由于FNA指出淀粉酶1280UI/L和CEA593.33ng/mL，因此在胃重复囊肿和外生性胰腺囊肿之间进行了鉴别诊断。尽管有抗生素预防,FNA后出现病变过度感染，可能是由于技术上无法完全引流囊肿。之后,该患者被转诊至手术，病理学家证实了胃重复囊肿的诊断。在此设置中，EUS程序获得了领先的发挥，对传统成像测试的补充，尽管其作用在报道的文献中尚未标准化。这里,我们描述并讨论我们的苛刻案例，我们提出了一种算法来简化和标准化诊断工作。
