Ectopic pancreatic pseudocyst and cyst presenting as a cervical and mediastinal mass - case report and review of the literature

Abstract

Ectopic pancreas in the mediastinum is extremely rare. We are reporting on a case of a twenty two year old woman who presented to our clinic with a large cervical mass. The CT scan revealed a cystic lesion in the anterior mediastinum. The patient underwent surgical resection by cervical approach. A Cystic mass with pseudocysts, cysts and complete pancreatic tissue were found in pathology. There were no signs of pancreatitis or malignancy. No recurrence was observed after a follow up of four years. We reviewed the case reports describing this rare condition in the medical literature.We conclude that the possibility of ectopic pancreatic tissue should be included in the differential diagnosis of anterior mediastinal cystic mass, though as a remote possibility. Surgery is probably needed for the diagnosis and treatment. Posterior mediastinal pseudocyst is a different entity associated with acute pancreatitis. In those cases surgery is not recommended. Our third conclusion is that pancreatic tissue should be actively sought, if a structure resembling a pseudocyst is found in an unexpected location.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1849369005957671

Pancreaticopleural and pancreaticomediastinal fistula extending to the cervical region, with dysphagia as initial symptom

“…[9–12] Another case of pancreatic fluid localized in the cervical region described by Rokach was associated with ectopic pancreatic tissue. [13]…”

Mediastinal Ectopic Pancreas with Abundant Endocrine Cells Coexisting with Mediastinal Cyst and Thymic Hyperplasia

“…Other symptoms include pneumonia, hemoptysis, fever, throat discomfort, night sweat, shoulder pain, and neck swelling [ 5 , 18 , 23 , 25 ]. Asymptomatic cases were also identified in 4 cases (13.4%) [ 3 , 6 , 13 , 20 ].…”

“…One case out of these four was reported to develop adenocarcinoma arising from the ectopic pancreatic tissues [ 18 , 23 , 24 ]. All benign cases were fully recovered after the operation and no recurrence was reported even years after surgery [ 20 , 24 ]. The patient who developed adenocarcinoma died 15 months after surgery [ 16 ].…”

“…Regarding the solid mediastinal ectopic pancreas, CT-scan cannot distinguish it from other solid masses such as thymoma, lymphoma, or malignant teratoma. In all these conditions, the diagnosis can be established only after surgery and histopathological examination [ 20 ].…”

Retraction Note: Gene expression profiles analysis identifies key genes for acute lung injury in patients with sepsis

“…The Publisher and Editor regretfully retract this article [ 1 ] because the peer-review process was inappropriately influenced and compromised. As a result, the scientific integrity of the article cannot be guaranteed.…”