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columnar ciliated epithelium is extremely rare. The very appearance of a gastric duplication cyst in an adult can present
a diagnostic dilemma. In majority of reported cases, the diagnosis is established during surgical exploration. We
report on a 34 year-old female patient suffering from repeated episodes of epigastric pain and gastroesophageal reflux.
Abdominal computed tomography and endoscopic ultrasound demonstrated a intramural lesion attached to the gastric
fundus, suggestive of gastrointestinal stromal tumor (GIST). At exploratory laparotomy a non-communicating cyst, was
found along the greater curvature of the stomach in the esophagogastric transition. The lesion was excised along with
an adjacent sleeve of the stomach and esophagus wall because shared muscular layer with the stomach and esophagus.
The final pathologic examination revealed that the inner wall of the cyst was lined by a pseudostratified columnar ciliated
epithelium (respiratory type) and, in part, columnar and gastric foveolar epithelium. Even though a panel of imaging
modalities is available, it is still difficult to obtain a preoperative diagnosis. Duplication cyst can be mistaken for
a soft tissue tumor of the gastrointestinal tract. There is no therapeutic algorithm. Surgical treatment is recommended
for symptomatic cases.