Adenocarcinoma Arising from an Ectopic Pancreas in the Stomach

Abstract

Ectopic pancreas is rare, being found in between 0.6 % and 15 % at autopsy. Heterotopic pancreas is usually an asymptomatic condition which is found incidentally at surgery or at autopsy. Occasionally, significant symptoms arise from complications, such as recurrent upper gastrointestinal bleeding, biliary or intestinal obstruction, or malignant degeneration. Malignant change is very rare. We report a case of malignant change (adenocarcinoma) in an ectopic pancreas in the stomach. In the literature, there are eight reported cases of malignant change in ectopic gastric pancreas. The prognosis in the other reported cases is unknown, but in our patient, the tumor was confined to the muscle of the stomach and there was no lymph node invasion.

Gastric outlet obstruction caused by heterotopic pancreas: A case report and a quick review

“…They postulated that size greater than 1.5 cm is more likely to be of clinical significance [8] . Other less common symptoms were bleeding mimicking jejunal tumor [9] , pancreatitis, and malignant transformation [10][11][12] . Macroscopically, the tissue often localized in the submucosa, but may also be found in the muscularis mucosa, subserously or in the serosa.…”

Analysis of diagnosis and treatment of heterotopic pancreas

“…(1) Pathological changes of heterotopic pancreas. Generally, heterotopic pancreas lesions are similar to any disease caused by normal pancreas, such as acute and chronic pancreatitis, pancreatic cyst, adenoma, adenocarcinoma, [12,13] and clinically manifested as acute and chronic abdominal pain, tumor, digestive tract multiple ulcer (Zollinger-Ellison syndrome), Whipple's triad syndrome (episodes of hypoglycemia, blood glucose below L 2.8mmol/L, oral administration or intravenous injection of glucose could relieve the symptoms). (2) In rare cases, heterotopic pancreas may be detected by the mass in abdominal wall, spermatic cord and other parts.…”

“…While, heterotopic pancreas in hepatobiliary system or Vater's ampulla of duodenum may present as jaundice and fever. [12] Despite the development of modern diagnostic modalities, its preoperative diagnosis remains challenging. Endoscopic ultrasonography, however, serves as a useful tool that aid in its identification with other diseases.…”

“…Patients with tumor changes are often not accompanied by lymph node invasion. [12] The diagnosis of heterotopic pancreas, differentiating with other pancreatic tumors heavily relies on immunohistochemistry, [20] a comprehensive analysis of [21] morphology, immunohistochemical characteristics and genes of it, such as the overexpression of P53. [22] 2.6 Dr. Shipeng Song Dr. Shipeng Song is the Associate Chief Physician of General surgery Department at the Third Affiliated Hospital of Inner Mongolia Medical University, specializing in minimally invasive surgery, organ transplantation.…”

Adenopatías mesentéricas en la enfermedad celiaca

“…La aparición de adenopatías mesentéricas en el contexto de una enfermedad celiaca no es habitual (1)(2)(3)(4). Presentamos el caso de una paciente con síndrome diarreico de un mes de evolución, con criterios de malabsorción y adenopatías mesentéricas de más de dos centímetros de diámetro, que fue diagnosticada de enfermedad celiaca.…”