Laparoscopic resection of cecal duplication cyst in a 28 years old male: a rare case report.

BACKGROUND

Cecal duplication cysts are a rare congenital anomaly, particularly uncommon in adults. With no clear etiology behind it, duplication cysts typically appear before 2 years of age. Their presentation is diverse, often mimicking other right lower quadrant pathologies. We report a case of an adult cecal duplication cyst treated successfully with laparoscopic resection, highlighting diagnostic challenges and management considerations.

CASE PRESENTATION: A 28-year-old man presented to our care with a one-week history of right lower quadrant pain. Initial ultrasound and CT scan suggested a paracecal cystic lesion, with differential diagnoses including cecal diverticulitis or epiploic appendagitis. Partially responsive to medical therapy, a repeat CT after 10 days was performed and showed an interval enlargement of the lesion with persistent fat stranding. Diagnostic laparoscopy revealed a cystic mass densely adherent to the cecal wall, sharing a common blood supply. Ileocecectomy with side-to-side ileocolic anastomosis was performed. Histopathology confirmed a cecal duplication cyst lined by colonic mucosa with a smooth muscle layer and no evidence of dysplasia or malignancy. The patient recovered uneventfully and remained asymptomatic at 6-month follow-up.

CONCLUSION

Cecal duplication cysts in adults are exceedingly rare, representing less than 0.5% of gastrointestinal duplications. Diagnosis is challenging due to overlapping clinical and radiologic features with more common conditions. Histopathology remains the gold standard for confirmation. Complete surgical resection is the treatment of choice, both to relieve symptoms and to mitigate risks of complications, including malignant transformation.