Heterotopic pancreas in the gastrointestinal tract

Abstract

Heterotopic pancreas is defined as pancreatic tissue found outside the usual anatomical location of the pancreas. It is often an incidental finding and can be found at different sites in the gastrointestinal tract. It may become clinically evident when complicated by pathological changes such as inflammation, bleeding, obstruction, and malignant transformation. In this report, a 60-year-old man with carcinoid syndrome caused by heterotopic pancreatic tissue in the duodenum is described, along with a 62-year-old man with abdominal pain caused by heterotopic pancreatic tissue in the gastric antrum. The difficulty of making an accurate diagnosis is highlighted. The patients remain healthy and symptom-free after follow-up of 1 year. Frozen sections may help in deciding the extent of resection intraoperatively. Although heterotopic pancreas is rare, it should be considered in the differential diagnosis of gastrointestinal stromal tumor.

Figure 1

Endoscopy showing a solid tumor mass under the mucosal membrane in the gastric antrum.

Figure 2

CT reconstruction showing a mass with a diameter of 2 cm in the gastric antrum.

Figure 3

Echogatstroscope revealing low-echogenicity mass under the gastric wall submucosal muscularis propria, with a clear boundary and uneven internal echogenicity.

Figure 4

Lobules of pancreatic tissue with ducts located within the smooth muscle of the pylorus (HE, × 100).