Invasive Ductal Carcinoma Arising from an Ectopic Pancreas in the Gastric Wall: A Long-Term Survival Case

Okamoto, Hiroyuki; Kawaoi, Akira; Ogawara, Tadahiko; Fujii, Hideki

doi:10.1159/000335870

Cited by 15 publications

(5 citation statements)

References 10 publications

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“…If malignancy is suspected extended oncological surgical resection (e.g., PPPD) is justified. The prognosis of patients with adenocarcinoma arising from PH seems to be better compared to patients with tumors arising from the pancreas itself, probably due to earlier presentation [ 16 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical impact of duodenal pancreatic heterotopia – Is there a need for surgical treatment?

et al. 2017

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BackgroundPancreatic heterotopia (PH) is defined as ectopic pancreatic tissue outside the normal pancreas and its vasculature and duct system. Most frequently, PH is detected incidentally by histopathological examination. The aim of the present study was to analyze a large single-center series of duodenal PH with respect to the clinical presentation.MethodsA prospective pancreatic database was retrospectively analyzed for cases of PH of the duodenum. All pancreatic and duodenal resections performed between January 2000 and October 2015 were included and screened for histopathologically proven duodenal PH. PH was classified according to Heinrich’s classification (Type I acini, ducts, and islet cells; Type II acini and ducts; Type III only ducts).ResultsA total of 1274 pancreatic and duodenal resections were performed within the study period, and 67 cases of PH (5.3%) were identified. The respective patients were predominantly male (72%) and either underwent pancreatoduodenectomy (n = 60); a limited pancreas resection with partial duodenal resection (n = 4); distal pancreatectomy with partial duodenal resection (n = 1); total pancreatectomy (n = 1); or enucleation (n = 1). Whereas 65 patients (83.5%) were asymptomatic, 11 patients (18.4%) presented with symptoms related to PH (most frequently with abdominal pain [72%] and duodenal obstruction [55%]). Of those, seven patients (63.6%) had chronic pancreatitis in the heterotopic pancreas. The risk of malignant transformation into adenocarcinoma was 2.9%. ConclusionsPH is found in approximately 5% of pancreatic or duodenal resections and is generally asymptomatic. Chronic pancreatitis is not uncommon in heterotopic pancreatic tissue, and even there is a risk of malignant transformation. PH should be considered for the differential diagnosis of duodenal lesions and surgery should be considered, especially in symptomatic cases.

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Section: Discussionmentioning

confidence: 99%

Clinical impact of duodenal pancreatic heterotopia – Is there a need for surgical treatment?

et al. 2017

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“…In 8 cases no information about tumor markers was reported. Of the remaining 10 cases carcinoembrionic antigen and carbohydrate antigen 19-9 were elevated in 30% of cases [ 31 , 34 , 36 ] and Ca72-4 elevated only in one case. [ 7 ] Majority of the tumors were located in antropyloric region (78%) with submucosal stenotic lesion protruding into the lumen and intact mucosa (61%).…”

Section: Discussionmentioning

confidence: 99%

“…Okamoto et al, [36] 2012 74, F Middle corpus Submucosal tumor Epigastralgia I Uneventful (11 yr) 2.0 × 2.0 × 2.0 Elevated Lemaire et al, [37] 2014 60, M Lesser curvature NR Dyspepsia and epigastric heaviness NR Disease-free (4 yr) 7.5 × 4.4 Elevated…”

Section: Tumour Markersmentioning

confidence: 99%

Aberrant pancreas adenocarcinoma in the stomach: A case report and literature review

et al. 2023

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Rationale: Aberrant pancreatic tissue in the gastrointestinal tract is a relatively common finding. However, malignant transformation is extremely rare. Herein, we report a case of ectopic pancreatic ductal adenocarcinoma in the stomach wall. Patient concerns: A 38 year old male presented with nausea, bloating, abdominal distention and weight loss for 4 months. Diagnoses: Endoscopy of upper gastrointestinal tract was performed twice with 2 months interval and a stenotic pyloric part was observed with a suspected submucosal lesion. It was sampled both times, however the pathology findings of the mucosal biopsies were unremarkable with no identifiable neoplastic structures. CT scan and MRI was performed and showed a thickened pyloric wall with a submucosal lesion 15 × 15 mm in diameter. Blood levels of tumor markers carcinoembrionic antigen and carbohydrate antigen 19-9 were within a normal range. Interventions: Pyloric stenosis progressed and the patient underwent a Billroth type I distal gastric resection with D2 lymphadenectomy. Pathologic examination revealed a well differentiated ductal adenocarcinoma arising in the heterotopic pancreatic tissue (Heinrich type III). The resection margins and lymph nodes were free of tumor. The patient received adjuvant chemotherapy with 6 courses of XELOX. Outcomes: No disease recurrence is reported in 12 months follow-up. Lessons: Aberrant pancreatic ductal adenocarcinoma in the stomach is a rare finding, however this pathology should be included in the differential diagnosis of gastric submucosal lesion causing pyloric stenosis.

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“…We performed a systemic search of the PubMed database for the English-language literature up to June 2020 using the search term ‘heterotopic pancreas’ and ‘ectopic pancreas’. Our review of the literature identified only five cases including ours published to date ( Table 1 ) [ [9] , [10] , [11] , [12] ]. The mean patient age was 75 (43–80) years; three patients were men (60%).…”

Section: Discussionmentioning

confidence: 99%

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

Matsubara

Ishida

Morito

et al. 2020

International Journal of Surgery Case Reports

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Invasive Ductal Carcinoma Arising from an Ectopic Pancreas in the Gastric Wall: A Long-Term Survival Case

Cited by 15 publications

References 10 publications

Clinical impact of duodenal pancreatic heterotopia – Is there a need for surgical treatment?

Clinical impact of duodenal pancreatic heterotopia – Is there a need for surgical treatment?

Aberrant pancreas adenocarcinoma in the stomach: A case report and literature review

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

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