Benign esophageal cysts are very rare embryonic malformations. In adults, esophageal cysts are mostly asymptomatic. Complications can occur due to mass effects. The diagnosis can be made using endoscopic ultrasonography (EUS), which is regarded as the diagnostic test of choice. It is a matter of debate whether relatively asymptomatic esophageal duplication cysts should be removed or whether conservative management is feasible. We report here on the case of a 37-year-old woman who presented with mild upper abdominal complaints and who was found to have compression of the distal lumen on barium esophagography. It was possible to diagnose an esophageal duplication cyst with EUS. In view of the absence of symptoms, it was decided to provide conservative management. During a 13-year follow-up period, no growth of the cyst was documented, nor did symptoms develop during this period. Close EUS observation may eliminate the need for surgery in asymptomatic patients.
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