Fig. 1Radiologic findings. (A) A hypoechoic mass with an echogenic dot (arrow) in the right lower quadrant is observed on ultrasonography. (B) A cystic mass with linear calcification in the mesentery adjacent to the ascending colon is observed on computed tomography.
Fig. 2Gross and microscopic findings. (A) The cystic mass measured 8.6×6.4×2.9 cm and contained brownish-colored mucoid material. (B) Full-thickness of two smooth muscle layers and adjacent mesenteric soft tissue are invaded by tumor cells. (C) The tumor is moderately differentiated adenocarcinoma. (D) A focal area of atypical columnar epithelium, compatible with dysplasia, is noted on the surface. (E) The dysplastic epithelial cells are positive for p53.
Table 1.Clinicopathologic summary of cases with adenocarcinoma arising in a colonic duplication cyst
Case |
Site |
Age (yr)/Sex |
Symptom |
Serum CEA |
Size (cm) |
Calcification |
Depth of invasion |
Treatment |
Prognosis |
1 [2] |
Cecum |
61/F |
Abdominal pain |
ND |
9 |
ND |
Muscle layer |
RHC, omentectomy, bilateral oophorectomy |
NED |
2 [3] |
Cecum |
50/F |
Lower abdominal pain |
ND |
8 |
ND |
Pericystic mesenteric soft tissue |
RHC |
ND |
3 [4] |
Cecum |
40/F |
Palpable mass |
↑ |
11 |
N |
Muscle layer |
RHC |
ND |
4 [5] |
Cecum |
41/M |
Palpable mass |
Normal |
6 |
Y |
Pericystic mesenteric soft tissue |
RHC, CT |
NED |
5 [1] |
Ascending |
41/F |
RLQ pain |
ND |
4 |
Y |
Thin fibrous wall (muscle layer) |
Excision |
NED |
6 [6] |
Ascending |
38/M |
Palpable mass |
↑ |
ND |
Y |
Capsule (muscle layer) |
RHC |
ND |
7 [6] |
Ascending |
59/F |
Fever and lumbar pain |
↑ |
ND |
Y |
Pericystic mesenteric soft tissue and right psoas muscle |
Excision |
ND |
8 [7] |
Ascending |
59/M |
Melena due to adenocarcinoma in the ascending colon |
ND |
10 |
ND |
Subserosa |
RHC |
ND |
9 [1] |
Transverse |
57/F |
RLQ pain |
ND |
11 |
ND |
Pericystic mesenteric soft tissue |
RHC |
NED |
10 [8] |
Transverse |
40/M |
Palpable mass |
ND |
16 |
ND |
Pericystic mesenteric soft tissue and omentum |
Excision, CT |
ND |
11 [4] |
Descending |
33/F |
Palpable mass |
ND |
15 |
N |
ND |
Excision |
ND |
12 [9] |
Sigmoid |
69/F |
Epigastric pain |
ND |
15 |
Y |
Pericystic mesenteric soft tissue and retroperitoneum |
Excision |
Died 41 mos later |
13 [10] |
Sigmoid |
72/F |
Epigastric pain due to cholelithiasis |
ND |
3 |
ND |
Subserosa |
Sigmoid colectomy |
ND |
Present case |
Ascending |
23/F |
Palpable mass |
↑ |
8.6 |
Y |
Pericystic mesenteric soft tissue |
Excision, CT |
NED |