PMC5352883_01
MR and US images of the abdominal mass. (a) Fetal ultrasonogram at 37 weeks' gestation: longitudinal section through the abdomen of the fetus shows a 4 x 3 cm cystic mass with sedimented echoes (arrow). (b) Fetal MR image at 28 weeks' gestation: axial T2-weighted image shows a cystic mass lesion in the right side of the fetal abdomen (arrow). (c) Postnatal longitudinal ultrasonogram on day 0 shows a 4.5 x 3.5 cm cystic mass with floating internal echoes in the right abdomen. Note the fluid-debris level (arrow) and muscular rim sign (arrowhead). (d) Axial T2-weighted MR image on postnatal day 16 reveals a hyperintense cyst in the left lower abdomen (arrow).
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The US revealed a 4 x 3 cm unilocular cystic mass with sedimented echoes in the fetal right quadrant, and no significant thickness or hyperechogenicity of the cyst wall was seen (Figure 1(a)). A fetal magnetic resonance imaging (MRI), which was performed at 28 weeks' gestation, revealed a unilocular cystic structure without a thick wall and solid components occupying the right side of the fetal abdomen (Figure 1(b)). On US, echogenic debris and septation were seen in the cyst, and a double-layered wall was seen over a small segment of the lowermost portion of the cyst wall (Figure 1(c)), which revealed the transient change in contour of the cyst. It showed a well-circumscribed cystic mass with a size of 3.8 x 3.5 x 3.0 cm in the left abdomen (Figure 1(d)).
(a) Intraoperative photograph of the thick-walled, 5 x 5 cm cyst (arrowhead) attached to the ileum (arrow). (b) Low-power photomicrograph (hematoxylin-eosin stain; original magnification, x100) shows histopathologic features of the enteric duplication cyst. The convergence of the cyst wall and the small-bowel wall can be seen. Duplication cyst mucosa of the duplication cyst including gastric mucosal lining (arrowhead) and mucosa of the native ileum (arrow) can be seen. The asterisk indicates the shared muscularis propria.
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On laparotomy, we observed a 5 x 5 x 3.5 cm cystic structure that was attached to the mesenteric border of the ileum, approximately 70 cm proximal to the ileocecal valve (Figure 2(a)). A histological examination revealed that the resected cyst and contiguous portion of the ileum shared a common muscular wall, although each had its own mucosal lining (Figure 2(b)).