PMC5362879_01
(a) Malignantly transformed duodenal duplication cyst in a longitudinal plane. The
asterisk shows the cystic portion. The white double-headed arrow shows the thickened
wall of the duodenal duplication cyst at the tumoral site (up to 9 mm). (b) Malignantly
transformed duodenal duplication cyst and duodenum in a transverse plane. The arrowhead
shows the duodenum with a thickened and hyperechoic wall. The white arrow shows the
thickened duodenal duplication cyst. No communication is seen between the duodenal lumen
and cystic portion of the duodenal duplication cyst
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Abdominal ultrasound showed a bi-lobed cystic mass-like structure that was closely associated with the duodenum (Figure 1a). Figure 1a), and a hyperechoic focus was seen within the wall of the mass. Focal loss of wall layering at the junction between the cavitated mass and the duodenum was seen and no connection to the duodenal lumen could be identified. The adjacent duodenal segment had thickened walls, focal loss of wall layering and a narrowed lumen (Figure 1b). This is similar to the present case, where the wall of the cystic mass was irregularly thickened with loss of wall layering (Figure 1a). Additionally, there was concurrent loss of wall layering of the adjacent duodenum (Figure 1b).
Gross image of the bi-lobed duodenal duplication cyst (arrowheads). The double-headed
arrow shows the resected portion of the duodenum
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The duodenal papilla was located approximately 3 cm oral to the mass, and a resection and anastomosis of the cystic duodenal mass was performed with no complications (Figure 2).