A Unique Case of Pancreatitis and Retention Cyst in Esophageal Heterotopic Pancreas

Abstract

Heterotopic pancreas is normal pancreatic tissue located in an abnormal location. Heterotopic pancreas in the esophagus is a rare congenital anomaly. We present a unique case of pancreatitis and retention cyst in a heterotopic pancreas in the esophagus, outline the investigation and management of cystic lesions of the distal esophagus, and review the literature.

Premalignant and Malignant Lesions of the Heterotopic Pancreas in the Esophagus: a Case Report and Review of the Literature

“…Before surgical resection, the lesion is frequently misdiagnosed as one of the most common submucosal tumors, gastrointestinal stromal tumor (GIST) or leiomyoma [2,6,31]. In many cases, the correct diagnosis is not determined until the histopathological examination of the resected specimen [6,[10][11][12][13][14]24].…”

“…The heterotopic pancreas is susceptible to the same pathological changes that occur in a normal pancreas, such as acute or chronic inflammation with fibrosis and pseudocyst formation [2,6,11,32]. Moreover, premalignant changes seem to occur with the same incidence in heterotopic and orthotopic pancreas.…”

“…An extensive sampling of such tumors is always necessary to evaluate the origin in the ectopic tissue and exclude the possibility of coincidental lesions. Up to date, there have been only 14 cases of esophageal heterotopic pancreas in adults reported in the literature with equal incidence between males and females (Table II) [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. Most patients suffered from dysphagia and epigastric pain, sometimes accompanied by signs of gastroesophageal reflux, nausea and rarely hematemesis.…”

“…Heterotopic pancreas can arise in any part of the gastrointestinal tract, most frequently in the stomach, duodenum or jejunum [2]. Up to now, there have been only 14 cases of heterotopic pancreas in the esophagus in adult patients documented in the literature [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. Ectopic tissue is usually discovered incidentally or may become symptomatic b e c a u s e o f o b s t r u c t i o n caused by enlargement due to inflammation, bleeding or malignant transformation [3,6,7].…”

A rare case of enlarged gastric heterotopic pancreas with retention cysts: A case report and literature review

“…Gananadha et al reported the first case of retention cysts in HP at the distal oesophagus. Although the enlargement was caused by pancreatitis, the authors concluded the importance and difficulty of the excluding malignancy [ 18 ]. They also emphasized that frozen section was useful for excluding malignancy and avoiding major surgery.…”