Enteric Duplication Cyst (Differential Diagnosis Tumor Posterior Mediastinum)

metu_18a_n.jpg: Lateral tomography of a 9-year-old girl with presentation of a rounded mass directly in front of the thoracic spine. Site and shape correspond most probably to an enteric duplication cyst. metu_18b_n.jpg and metu_18c_n.jpg: The diagnosis of an enteric duplication cyst is confirmed by the operative findings and the preparation. The cyst which is grasped with a Péan's forceps exhibits a fibrous connection to the esophagus. The latter lies in a longitudinal-oval zone with retracted borders of the mediastinal pleura. An atelectasis of the lung is visible which is held to the side by a swab and a retractor. The removed cyst has been opened to some degree, and mucus is leaking out. Enteric duplication cysts may lead to dysphagia due to the neighborhood of the esophagus mainly if they are increasing because of mucus accumulation. Gastric mucuous membrane as part of the inner lining may lead to exulceration with acute bleeding. If malformations of the thoracic spine are present (e.g. anterior bifid vertebra) the possibility of a neurenteric cyst has to be considered which is related developmentally to the enteric duplication cyst.