Heterotopic pancreas in the stomach: A case report and literature review

Christodoulidis, Grigorios; Zacharoulis, Dimitris; Barbanis, Sotirios; Katsogridakis, Emmanuel; Hatzitheofilou, Konstantine

doi:10.3748/wjg.v13.45.6098

Cited by 116 publications

(86 citation statements)

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“…It may occur on either the posterior or the anterior wall, and is more common along the greater curvature (11). The involvement of the submucosal layer occurs in 73% of cases, the muscularis propria is involved in 17%, and subserosal layer involvement occurs in 10% of cases (12). In some cases, HP stretches through several or all of the layers of the stomach (10).…”

Section: Discussionmentioning

confidence: 99%

Endoscopic mucosal resection/endoscopic submucosal dissection for gastric heterotopic pancreas

Shi²,

Lq³

et al. 2013

Turk J Gastroenterol

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Section: Discussionmentioning

confidence: 99%

Endoscopic mucosal resection/endoscopic submucosal dissection for gastric heterotopic pancreas

Shi²,

Lq³

et al. 2013

Turk J Gastroenterol

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“…By contrast, an HP is rarely found in the esophagus, common bile duct, gallbladder, mesentery, spleen, mediastinum or fallopian tubes (19). In the stomach, >95% of lesions are found in the antrum, mainly situated close to the greater curvature (20).…”

Section: Discussionmentioning

confidence: 98%

Gastric heterotopic pancreas masquerading as a stromal tumor: A case report

Lin

et al. 2015

Oncology Letters

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Abstract. Heterotopic pancreas (HP), a rare condition that is generally asymptomatic, is an aberration in the developmental profile of the pancreas. While it can occur in any location in the gastrointestinal tract, it is most typically found in the antrum of the stomach and is usually wrongly considered to be a submucosal tumor (SMT). Despite advances in diagnostic modalities, a HP still poses a diagnostic dilemma to clinicians. Invasive surgery or endoscopic resection have often been inappropriately applied in cases of an ectopic pancreas due to the difficulty in distinguishing it from neoplastic SMTs, such as gastrointestinal stromal tumors (GISTs). The present study reports the unusual case of a middle-aged female with an SMT at the lesser curve of the mid-body of the stomach, which was initially diagnosed as a GIST through endoscopic ultrasonography and computed tomography. However, following removal by endoscopic submucosal dissection, this lesion was finally histopathologically confirmed as an HP. Therefore, although it is rare, the possibility of an HP should always be considered when diagnosing an extramucosal gastric mass. The precise pre-operative diagnosis of this entity may avoid unnecessary extensive treatment intervention. IntroductionHeterotopic pancreas (HP), also known as ectopic or aberrant pancreas, is a congenital disorder with an occurrence rate of 0.5-13% in the general population (1). HP has no any vascular or anatomical communication with the normal pancreas, yet exhibiting the histological features of pancreatic acinar formation, the development of ducts and the presence of islets of Langerhans, with an independent blood supply (2-4). The heterotopic organ often remains silent, but may occasionally be symptomatic, including gastrointestinal bleeding, gastric outlet obstruction, gastric ulceration, pancreatitis and even malignant degeneration (5-7).Appearing as intraluminal protrusions with normal overlying mucosa, HPs are usually diagnosed as submucosal tumors (SMTs) at first during routine endoscopy. Despite the advent of novel diagnostic modalities, including endoscopic ultrasonography (EUS), computer tomography (CT) and even EUS-guided fine-needle aspiration (EUS-FNA), the differentiation from a neoplasm remains a clinical challenge (8-10). Invasive surgery or endoscopic resection are often inappropriately performed in HP cases due to tissue sampling errors and the difficulty in forming a pre-operative diagnosis on imaging (11,12). However, asymptomatic HP is benign and can be monitored long-term without further intervention. Therefore, the ability to pre-operatively distinguish HPs from neoplastic SMTs, such as gastrointestinal stromal tumors (GISTs), is extremely important.The present study describes a case with a lesion located on the lesser curvature of the gastric body, which was initially diagnosed as GIST through EUS and CT, until finally being confirmed as an HP. The study also presents a brief literature review concerning this relatively rare disorder. Written informed consen...

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“…The incidence in postmortem studies vary from 0.5 to 13.7%, more commonly in males (10). The most common locations are the stomach, duodenum and jejunum (10).…”

Section: Discussionmentioning

confidence: 99%

“…The incidence in postmortem studies vary from 0.5 to 13.7%, more commonly in males (10). The most common locations are the stomach, duodenum and jejunum (10). Also, it has been reported in association with duodenal diverticula (11,12).…”

Section: Discussionmentioning

confidence: 99%