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. 2020 Apr 22;6(1):80.
doi: 10.1186/s40792-020-00846-5.

Pancreatic ductal adenocarcinoma in colonic wall: metastatic disease or cancerized pancreatic ectopic tissue?

Graziana Gallo  1 , Alessandro Mangogna  2 , Gianrocco Manco  3 , Stefania Caramaschi  1 , Tiziana Salviato  1
Affiliations

Pancreatic ductal adenocarcinoma in colonic wall: metastatic disease or cancerized pancreatic ectopic tissue?

Graziana Gallo et al. Surg Case Rep. .

Abstract

We describe two unusual cases of cancerized ectopic pancreatic parenchyma within the wall of the left colon. Although the morphology of the neoplastic cells and their immunoprofile were consistent with pancreatic ductal adenocarcinoma, the detection of small foci of regular ectopic pancreatic tissue close to dysplastic glands at the periphery of the cancerized mass represented the key diagnostic features. A careful histological examination of surgical samples represents the correct approach to the diagnosis of this rare disease, mostly when total-body CT scan evaluation confirms the lack of bilio-pancreatic masses.

Keywords: Adenocarcinoma; Colon; Ectopic pancreas.

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Conflict of interest statement

No potential conflict of interest relevant to this letter was reported.

Figures

Fig. 1
Fig. 1
Case of a 74-year-old male. a Well differentiated pancreatic ductal adenocarcinoma near dilated, pancreatic gland in the bowel wall exhibiting architectural and cytologic atypia [hematoxylin and eosin (H&E) stain; 4×]. b Tumor cells are negative for CDX2 in neoplastic glands, compared to normally immunoreactive colonic mucosa (10×). c Complementary CK7 positivity of neoplastic glands and negativity of the non-neoplastic colonic mucosa (10×). d Atypical pancreatic glands close to normal pancreatic glands (H&E stain; 4×). Case of a 78-year-old female. e Well differentiated pancreatic ductal adenocarcinoma near to the pancreatic gland in the bowel wall (H&E stain; 4×). f Immunohistochemistry (IHC) shows negativity for CDX2 in neoplastic glands associated to positivity in the normal colonic mucosa (10×). g IHC shows positivity for CK7 in neoplastic glands associated to negativity in the normal colonic mucosa (10×). h Dysplastic pancreatic glands (H&E stain; 4×). Scale bars 100 μm
See this image and copyright information in PMC

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