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. 2019 Aug 6;5(1):126.
doi: 10.1186/s40792-019-0684-8.

Adenocarcinoma arising from an ectopic pancreas in the duodenum: a case report

Tsukasa Kaneko  1 , Masanori Ohara  2 , Kunishige Okamura  2 , Aki Fujiwara-Kuroda  2 , Daisuke Miyasaka  3 , Takumi Yamabuki  2 , Ryo Takahashi  2 , Kazuteru Komuro  2 , Masato Suzuoki  3 , Nozomu Iwashiro  2 , Mototsugu Kato  4 , Noriko Kimura  5 , Hiroshi Kijima  6 , Toru Nakamura  7 , Satoshi Hirano  7
Affiliations

Adenocarcinoma arising from an ectopic pancreas in the duodenum: a case report

Tsukasa Kaneko et al. Surg Case Rep. .

Abstract

Background: The malignant transformation of an ectopic pancreas in the duodenum is extremely rare. Herein, we report a case of an adenocarcinoma that arose from an ectopic pancreas. We also reviewed 14 cases of malignant transformations arising from an ectopic pancreas in the duodenum that were previously published.

Case presentation: An 81-year-old man with a 1-month history of vomiting was admitted to our institution. Esophagogastroduodenoscopy (EGD) and computed tomography (CT) scans revealed an obstruction at the first part of the duodenum. A distal gastrectomy was performed for diagnostic and therapeutic purposes. The histopathological examination of the resected specimen showed adenocarcinoma that arose from an ectopic pancreas (Heinrich type 1). The patient is alive without relapse at 18 months of follow-up.

Conclusions: Adenocarcinoma that arises from an ectopic pancreas should be considered when an obstruction is identified in the duodenum.

Keywords: Cancer-induced vomiting; Distal gastrectomy; Duodenal adenocarcinoma; Ectopic pancreas.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Esophagogastroduodenoscopy showing the obstruction at the first part of the duodenum. Arrow: pylorus ring. Arrow head: obstruction of the first part of the duodenum
Fig. 2
Fig. 2
Enhanced multi-detector row computed tomography (MDCT) image showing the wall thickness in the duodenum in the transverse (a) and the coronal (b) planes. Arrow heads: wall thickness of the first part of the duodenum
Fig. 3
Fig. 3
Schema of the operative findings. LN, Lymph node; T, Tumor
Fig. 4
Fig. 4
Resected specimen (gastric antrum and duodenum). Arrow heads: tumor. Arrow: pyloric ring
Fig. 5
Fig. 5
a Ectopic pancreas of the duodenum showing pancreatic ducts, acinar cells, and islets called Heinlich type1. b Adenocarcinoma in the duodenum mainly located in extra-mucosal layer, and combined with ectopic pancreas, which is consistent with carcinoma derived from ectopic pancreas. Magnified figures in the square are shown in c (yellow) and d (blue). c Papillary adenocarcinoma of the duodenum derived from ectopic pancreas. d Ectopic pancreatic tissue composed of pancreatic ducts and islets in duodenal muscle layer
See this image and copyright information in PMC

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