Esophageal duplication cyst recurrence: case report and literature review

: Esophageal duplication cysts are rare congenital malformations, although most cases are diagnosed in childhood, in adult patients the disease is often symptomatic and requires invasive treatment. This kind of cyst can be found during endoscopy or Chest-X-Ray, but elective investigations consist in chest computed tomography (CT) scan or magnetic resonance imaging (MRI), if necessary, together with gastroscopy performed with endoscopic ultrasound (EUS). The therapeutic alternatives currently available are the surgical or endoscopic approach. In the past surgery was performed in thoracotomy, but several authors have reported cases treated with a minimally invasive approach with excellent short-term and long-term results. We present a case report of a 59-year-old Caucasian woman, affected by esophageal duplication cyst, and treated in 2003 with surgical fenestration in right triportal video-assisted thoracoscopic surgery (VATS) with complete regression of symptoms and resumption of normal nutrition. The cyst recurred in 2019 and the patient underwent further surgery with removal of the cyst in the right uniportal VATS. Postoperative course was regular, the symptoms disappeared, and no complications occurred. During follow-up, chest CT scan showed a complete pathological resolution without cystic recurrence. Currently, many authors agree that the minimally invasive surgical approach is the treatment of choice for esophageal duplication cysts. Our case report shows that VATS is efficient and safe even in treatment of surgical recurrences.