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Case Reports
. 2009 Jun 22:7:54.
doi: 10.1186/1477-7819-7-54.

Ectopic pancreatic-type malignancy presenting in a Meckel's diverticulum: a case report and review of the literature

Hoey C Koh  1 , Blaithin Page, Catherine Black, Ian Brown, Stuart Ballantyne, David J Galloway
Affiliations
Case Reports

Ectopic pancreatic-type malignancy presenting in a Meckel's diverticulum: a case report and review of the literature

Hoey C Koh et al. World J Surg Oncol. .

Abstract

Background: Neoplasms arising from Meckel's diverticulae reported in the literature are mainly carcinoid tumours, gastrointestinal stromal tumours, and gastric or intestinal adenocarcinomas.

Case presentation: We describe a 50-year-old man who presented with rectal bleeding and anaemia, later found to be caused by a pancreatic adenocarcinoma arising from ectopic pancreatic tissue in a Meckel's diverticulum. The tumour was unfortunately highly aggressive, and the patient passed away within 5 months of symptom onset.

Conclusion: We believe this is the first case of pancreatic adenocarcinoma in a Meckel's diverticulum to be reported in the literature. The diagnosis of Meckel's should be considered in patients with acute gastrointestinal complaints; when found incidentally at laparotomy, it should be carefully examined for any gross abnormality and resection should be considered.

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Figures

Figure 1
Figure 1
MRI enteroclysis. Green arrow shows a 22 mm peripherally enhancing soft tissue lesion in the right iliac fossa.
Figure 2
Figure 2
CT enterography. Green arrow shows a mass lesion arising from either the appendix or a Meckel's diverticulum.
Figure 3
Figure 3
Histology and immunoprofile of pancreatic type adenocarcinoma. The malignant glands (arrows in A) are highlighted by cytokeratin expression (B). The poorly differentiated single tumour cells infiltrating the tissue surrounding the ectopic pancreatic islets are difficult to identify with the conventional haematoxylin and eosin (H&E) section (arrows in C), but are highlighted by cytokeratin (D). The islets (E) express neuroendocrine markers, and specific pancreatic islet cell markers insulin (F) and glucagon.
Figure 4
Figure 4
4a shows a dramatic increase in the volume of tumour encountered in the 2nd operation, merely 2 weeks after the 1st operation of tumour resection. 4b shows a significant increase in the size, number and extent of peritoneal deposits.
See this image and copyright information in PMC

References

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