esophageal duplication cyst presenting with dysphagia in a middle-aged male: a case report

Esophageal duplication cysts (edcs) are rare congenital foregut anomalies often presenting with nonspecific gastrointestinal (gi) symptoms in childhood. diagnosis requires a high index of suspicion and comprehensive work-up. we report a 56-yearold male with type 2 diabetes mellitus and benign prostatic hyperplasia. he presented with a one-month history of intermittent, burning epigastric pain exacerbated by eating and accompanied by nausea. physical examination revealed mild epigastric tenderness. upper gi endoscopy showed a bulging lesion in the lower esophagus, a large cardia polyp, a small gastric body polyp, and antral erythema. endoscopic ultrasound (eus) identified a well-defined, homogeneous, round lesion (33 × 20 mm)esophageal duplication cysts (edcs) are rare congenital foregut anomalies often presenting with nonspecific gastrointestinal (gi) symptoms in childhood. diagnosis requires a high index of suspicion and comprehensive work-up. we report a 56-yearold male with type 2 diabetes mellitus and benign prostatic hyperplasia. he presented with a one-month history of intermittent, burning epigastric pain exacerbated by eating and accompanied by nausea. physical examination revealed mild epigastric tenderness. upper gi endoscopy showed a bulging lesion in the lower esophagus, a large cardia polyp, a small gastric body polyp, and antral erythema. endoscopic ultrasound (eus) identified a well-defined, homogeneous, round lesion (33 × 20 mm)demonstrating acoustic enhancement in the lower esophagus. contrast-enhanced abdominopelvic computed tomography (ct) revealed an intraluminal, non-enhancing lesion (25 × 26 mm) at the lower esophageal sphincter (les), suggestive of a duplication cyst. thoracic imaging showed no abnormalities. due to persistent symptoms, the patient underwent successful video-assisted thoracoscopic surgery without complications; no recurrences occurred during follow-up. edcs should be considered in the differential diagnosis of submucosal or intraluminal esophageal lesions, even in adults despite their rarity. eus yields high accuracy in characterizing these lesions. thoraco-abdominal ct scans delineate relationships to surrounding structures. for symptomatic lesions, video-assisted thoracoscopic surgery demonstrates a successful outcome with low complication rates.