ECTOPIC PANCREATIC TISSUE IN THE STOMACH: CASE REPORT
Introduction: Etopic pancreas is a rare developmental anomaly. It is presence of pancreatic tissue without anatomic or vascular continuity with the normally developed pancreas. The most common heterotopic site is the stomach commonly involving antrum and prepyloric region on the greater curvature or posterior wall. Ectopic pancreas is diagnosed by endoscopic ultrasound, gastroscopy and biopsy, CT scan and MRI of the abdomen, a definitive diagnosis is verified by histopathological examination. Treatment is surgical.
Case report: A 56-year-old woman presented with epigastric pain, nausea and fatigue. Esophagogastroduodenoscopy showed submucosal mass in the prepyloric region, biopsy was performed. Histopatological findings described normal gastric mucosa. Endoscopic ultrasonogpraphy and CT of the abdomen showed submucosal tumor, 18 mm in diameter, located in the prepyloric region. Surgical treatment was indicated. Gastrotomy with total extraction of tumor was performed. Histopathology findings showed ectopic pancreatic tissue in the submucosal and muscular layer of the stomach. Postoperatively patient fully recovered, and in the 2 year folow-up did not develop any symptoms related to gastrointestinal tract.
Conclusion: Although presentation of ectopic pancreatic tissue in stomach is very rare condition, it should be considered during gastroitestinal diagnostic in patients with nonspecific gastrointestinal symptomatology. In most of cases, for this patients, surgery is curative and definitive solution.
Ormarsson OT, Gudmundsdottir I, Marvik R. Diagnosis and treatment of gastric heterotopic pancreas. World J Surg. 2006; 30(9): 1682-9.
Christodoulidis G, Zacharoulis D, Barbanis S, Katsogridakis E, Hatzitheofilou K. Heterotopic pancreas in the stomach: a case report and literature review. World J Gastroenterol. 2007;13(45):6098-100.
Chandan VS, Wang W. Pancreatic heterotopia in the gastric antrum. Arch Pathol Lab Med. 2004;128(1): 111-2.
Eisenberger CF, Gocht A, Knoefel WT, Busch CB, Peiper M, Kutup A, et al. Heterotopic pancreas--clinical presentation and pathology with review of the literature. Hepatogastroenterology. 2003; 51(57):854-8.
Pang LC. Pancreatic heterotopia: a reappraisal and clinicopathologic analysis of 32 cases. South Med J. 1988; 81(10):1264-75.
Matsushita M, Hajiro K, Okazaki K, Takakuwa H. Gastric aberrant pancreas: EUS analysis in comparison with the histology. Gastrointest Endosc. 1999; 49(4Pt1): 493-7.
Low G, Panu A, Millo N, Leen E. Multimodality imaging of neoplastic and nonneoplastic solid lesions of the pancreas. Radiographics. 2011;31(4):993–1015. Shetty A, Paramesh AS, Dwivedi AJ, et al. Symptomatic ectopic pancreas. Clinical. Review. 2002;58:203–207.
Tanaka K, Tsunoda T, Eto T, Yamada M, Tajima Y, Shimogama H, et al. Diagnosis and management of heterotopic pancreas. Int Surg. 1993;78(1):32–5.
Klob L. Pancreas accesorium. Zeitschrift der Kaiserl. Konigl. Gesellschaft der Aerzte zu Wien. 1859;15:732.
Caberwal D, Kogan SJ, Levitt SB. Ectopic pancreas presenting as an umbilical mass. J Pediatr Surg. 1977;12(4):593–9.
Heller RS, Tsugu H, Nabeshima K, Madsen OD. Intracranial ectopic pancreatic tissue. Islets. 2010;2(2):65–71.
Jaschke W, Aleksic M, Aleksic D. Heterotopic pancreatic tissue in a bronchogenic cyst-diagnosis and therapy. Thorac Cardiovasc Surg. 1982;30(1):58–60.
Szabados S, Lenard L, Tornoczky T, Varady E, Verzar Z. Ectopic pancreas tissue appearing in a mediastinal cyst. J Cardiothorac Surg. 2012;7:22.
Hsia CY, Wu CW, Lui WY. Heterotopic pancreas: a difficult diagnosis. J Clin Gastroenterol. 1999;28(2):144–7.
Emerson L, Layfield LJ, Rohr LR, Dayton MT. Adenocarcinoma arising in association with gastric heterotopic pancreas: a case report and review of the literature. J Surg Oncol. 2004;87(1):53–7.
Papaziogas B, Koutelidakis I, Tsiaousis P, Panagiotopoulou K, Paraskevas G, Argiriadou H, et al. Carcinoma developing in ectopic pancreatic tissue in the stomach: a case report. Cases J. 2008;1(1):249.
Galatioto C, Goletti O, Franceschi M, Buccianti P, Neri E, Amillota N, et al. Laparoendoscopic treatment of gastric ectopic pancreas. Surg Laparosc Endosc Percutan Tech. 1999;9:160–4.
Christodoulidis G, Zacharoulis D, Barbanis S, Katsogridakis E, Hatzitheofilou K. Heterotopic pancreas in the stomach: a case report and literature review. World J Gastroenterol. 2007;13(45):6098–100.
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