Resection of anterior mediastinal ectopic pancreas by right thoracoscopy: A case report

Abstract

Ectopic pancreas is uncommon in the anterior mediastinum. Herein, a 32-year-old woman presented to our institution for investigation of an abnormal mediastinal shadow on chest computed tomography. The patient underwent complete surgical resection of the anterior mediastinal mass by right thoracoscopy, and the postoperative pathology examination confirmed the diagnosis of ectopic pancreas. There were no clinical signs of pancreatitis. No recurrence or metastasis was observed during a follow-up period of 3 years. English language medical literature was also searched in order to identify other case reports describing this rare condition and identified 17 papers describing 20 cases of anterior mediastinal ectopic pancreas, which were all confirmed at surgery. All clinical characteristics in these cases were reviewed.

Keywords: anterior mediastinal mass; ectopic pancreas; thoracoscopy.

Figure 1.

Chest CT. The preoperative scan shows a cystic-solid mass measuring 3.6×3.9 cm and situated mainly on the left side of the anterior mediastinum; a follow-up scan at 3 years after surgery shows no tumor recurrence. CT, computed tomography.

Figure 2.

Hematoxylin/eosin staining and immunohistochemistry. Microscopy shows a normal acinar structure in the solid portion of the mass and pancreatic acini and islet cells in the wall of the cystic portion. Immunostaining is positive for islet cell insulin and cystic alpha-ACT, CK19, and CK20.