Heterotopic Pancreatic Pseudocyst Radiologically Mimicking Gastrointestinal Stromal Tumor

Sarsenov, Dauren; Tırnaksız, Mehmet Bülent; Doğrul, Ahmet; Tanas, Özlem; Gedikoğlu, Gökhan; Abbasoğlu, Osman

doi:10.9738/intsurg-d-13-00242.1

Cited by 8 publications

(9 citation statements)

References 22 publications

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“…In the stomach, heterotopic pancreas may resemble gastrointestinal stromal tumors, the most prevalent submucosal gastric lesions. 5 , 6 This similarity lies not only in the shared physical appearance but also the fact that both masses are found in the submucosal layer. 6 This difficulty in correctly distinguishing between pancreatic heterotopia and a tumor has been noted to persist even with the use of advanced imaging techniques.…”

Section: Discussionmentioning

confidence: 88%

Submucosal Tunneling Endoscopic Resection for the Management of Heterotopic Pancreas With Cystic Degeneration

Almazan

Runge

et al. 2020

ACG Case Rep J

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Heterotopic pancreas is pancreatic tissue present outside of the normal location of the pancreas. In the presence of cystic degeneration, heterotopic pancreas is clinically significant because of the symptoms it causes and its physical resemblance to cancerous growth. A diagnosis of heterotopic pancreas is achieved with the aid of various endoscopic techniques for tissue removal. Submucosal tunneling endoscopic resection has proven successful for the resection of gastric subepithelial masses. We present a 53-year-old woman undergoing submucosal tunneling endoscopic resection for the resection of a subepithelial gastric cyst caused by heterotopic pancreas with cystic degeneration.

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Section: Discussionmentioning

confidence: 88%

Submucosal Tunneling Endoscopic Resection for the Management of Heterotopic Pancreas With Cystic Degeneration

Almazan

Runge

et al. 2020

ACG Case Rep J

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“…Manifestations of acute and chronic pancreatitis in HP tissues were the second most common presentation in our review. Clinical symptoms may include abdominal pain, nausea, vomiting, anorexia and weight loss[ 85 , 163 ]. Similar to orthotopic pancreatitis, the most common causes can be related to alcohol, medications, smoking, autoimmune disease or inadequate ductal drainage[ 243 ].…”

Section: Discussionmentioning

confidence: 99%

“…Lesions that are small and otherwise asymptomatic for decades, may also become acutely symptomatic in setting of inflammation and edema[ 60 , 92 ]. Likewise, the development of cysts and fluid collections within the wall of the stomach may grow to a size that can impede gastric emptying[ 163 ]. Some have also proposed that HP lesions may cause functional obstruction due to pyloric spasm[ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical classification of symptomatic heterotopic pancreas of the stomach and duodenum: A case series and systematic literature review

LeCompte¹,

Mason²,

Robbins³

et al. 2022

WJG

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BACKGROUND Heterotopic pancreas (HP) is an aberrant anatomic malformation that occurs most commonly in the upper gastrointestinal tract. While the majority of heterotopic pancreatic lesions are asymptomatic, many manifest severe clinical symptoms which require surgical or endoscopic intervention. Understanding of the clinical manifestations and symptoms of HP is limited due to the lack of large volume studies in the literature. The purpose of this study is to review symptomatic cases at a single center and compare these to a systematic review of the literature in order to characterize common clinical manifestations and treatment of this disease. AIM To classify the common clinical manifestations of heterotopic pancreas. METHODS A retrospective review was conducted of pathologic samples containing heterotopic pancreas from 2000-2018. Review was limited to HP of the upper gastrointestinal tract due to the frequency of presentation in this location. Symptomatic patients were identified from review of the medical records and clinical symptoms were tabulated. These were compared to a systematic review of the literature utilizing PubMed and Embase searches for papers pertaining to heterotopic pancreas. Publications describing symptomatic presentation of HP were selected for review. Information including demographics, symptoms, presentation and treatment were compiled and analyzed. RESULTS Twenty-nine patient were identified with HP at a single center, with six of these identified has having clinical symptoms. Clinical manifestations included, gastrointestinal bleeding, gastric ulceration with/without perforation, pancreatitis, and gastric outlet obstruction. Systemic review of the literature yielded 232 publications detailing symptomatic cases with only 20 studies describing ten or more patients. Single and multi-patient studies were combined to form a cohort of 934 symptomatic patients. The majority of patients presented with abdominal pain (67%) combined with one of the following clinical categories: (1) Dyspepsia, ( n = 445, 48%); (2) Pancreatitis ( n = 260, 28%); (3) Gastrointestinal bleeding ( n = 80, 9%); and (4) Gastric outlet obstruction ( n = 80, 9%). The majority of cases ( n = 832, 90%) underwent surgical or endoscopic resection with 85% reporting resolution or improvement in their symptoms. CONCLUSION Heterotopic pancreas can cause significant clinical symptoms in the upper gastrointestinal tract. Better understanding and classification of this disease may result in more accurate identification and treatment of this malformation.

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“…Histological analysis showed that numerous acini, few ducts and some endocrine islets were found in the submucosa, muscularis propria and serosa; thus, a type I lesion was considered according to the Heinrich and Gaspar-Fuentes classification. Previous studies have reported that cystic changes can be seen in EP tissue and that retention cysts are usually small (less than 1–2 cm in size) and lined by a single layer of normal pancreatic epithelium, whereas pseudocysts are usually larger with walls that lack an epithelial lining [ 13 , 14 ]. Furthermore, pancreatic cysts are classified as neoplastic or nonneoplastic.…”

Section: Discussionmentioning

confidence: 99%

Ectopic pancreas appearing as a giant gastric cyst mimicking gastric lymphangioma: a case report and a brief review

Liu

Tuo

et al. 2021

BMC Gastroenterol

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Background Ectopic pancreas (EP) is defined as pancreatic tissue that lacks anatomical or vascular communication with the normal body of the pancreas. Despite improvements in diagnostic endoscopy and imaging studies, differentiating ectopic pancreatic tissue from gastric submucosal diseases remains a challenge. Case presentation Here, we present a case of a 44-year-old woman with severe epigastric pain. Initially, gastric lymphangioma was highly suspected due to a well-demarcated protruding mass with a large size that occurred in the submucosal layer of the gastric antrum and appeared as a cystic lesion. The final correct diagnosis of gastric EP was made during surgery. Conclusion Gastric EP with serous oligocystic adenoma appearing as a giant gastric cyst is extremely rare. The difficulty of making an accurate diagnosis and differential diagnosis is highlighted, which may provide additional clinical experience for the diagnosis of EP with serous oligocystic adenoma in the stomach.

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Heterotopic Pancreatic Pseudocyst Radiologically Mimicking Gastrointestinal Stromal Tumor

Cited by 8 publications

References 22 publications

Submucosal Tunneling Endoscopic Resection for the Management of Heterotopic Pancreas With Cystic Degeneration

Submucosal Tunneling Endoscopic Resection for the Management of Heterotopic Pancreas With Cystic Degeneration

Clinical classification of symptomatic heterotopic pancreas of the stomach and duodenum: A case series and systematic literature review

Ectopic pancreas appearing as a giant gastric cyst mimicking gastric lymphangioma: a case report and a brief review

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