Gastric fundal heterotopic pancreas mimicking a gastrointestinal stromal tumour (GIST): a case report and a brief review

Abstract

Background: Heterotopic pancreas is a rare congenital condition characterised by pancreatic tissue lacking vascular or anatomic communication with the normal pancreas. Most cases of ectopic pancreas are asymptomatic. The preoperative diagnosis of this condition is difficult.

Case presentation: A 50-year-old woman presented with dyspeptic symptoms of 4 years duration. Contrast enhanced CT (computed tomography) scan of abdomen suggested a gastrointestinal stromal tumour in the fundus of the stomach. The patient underwent laparoscopy assisted resection and subsequent histology revealed ectopic pancreatic tissue.

Conclusion: Although heterotopic pancreas is a rare lesion diagnosed on histology, it should be considered in the differential diagnosis of gastric mass lesions and in patients presenting with vague upper gastrointestinal symptoms.

Keywords: Endoscopy; Heterotopic pancreas; Stomach; Surgery.

Fig. 1

Upper gastrointestinal endoscopy showing gastric fundal mass

Fig. 2

Upper GI endosonography showing a mass lesion in the fundus of stomach

Fig. 3

Contrast CT abdomen showing enhancing mass on the anterior gastric wall

Fig. 4

Laparoscopic resection of the gastric fundal mass

Fig. 5

Resected specimen containing tumour

Fig. 6

Heterotopic pancreatic tissue (HP) in the submucosa of stomach (a, b). c Heterotopic pancreatic tissue (HP) in the muscularis propria (MP), GM Normal gastric mucosa with glands