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Case Reports
. 2020 May 26;8(10):1979-1987.
doi: 10.12998/wjcc.v8.i10.1979.

Heterotopic pancreas adenocarcinoma in the stomach: A case report and literature review

Yao Xiong  1 , Yue Xie  1 , Dan-Dan Jin  1 , Xin-Ying Wang  2
Affiliations
Case Reports

Heterotopic pancreas adenocarcinoma in the stomach: A case report and literature review

Yao Xiong et al. World J Clin Cases. .

Abstract

Background: Heterotopic pancreas is a common lesion found in the gastrointestinal tract and is usually considered a benign disease. Reports of malignant change of heterotopic pancreas are scarce.

Case summary: A 44-year-old Chinese female underwent a gastroscopy to assess abdominal distension that had persisted for 2 months. A protruding lesion in the gastric antrum was revealed but no malignant tissue was found in the biopsy specimen. The patient's symptom persisted and progressed to repeated vomiting. Endoscopy after 4 months revealed obstruction of the gastric outlet caused by the protruding lesion. A distal gastrectomy was performed. Histopathological examination of the surgical specimen showed the malignant transformation of aberrant pancreas in the stomach. Chemotherapy consisting of folinic acid, fluorouracil, and oxaliplatin was administered for three cycles, and was changed to gemcitabine monotherapy because of adverse effects and increased serum tumor marker levels. The patient remained asymptomatic during a 12-month follow-up.

Conclusion: Pancreatic heterotopy should be considered as source of a potentially malignant lesion, and early treatment or close monitoring for aberrant pancreas is recommended.

Keywords: Adenocarcinoma; Case report; Heterotopic pancreas; Pyloric obstruction; Stomach.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Radiologic and endoscopic features of the tumor. A: Gastroscopy showed a nodular protruding lesion at the gastric antrum and stenosis of the pyloric ring; B: Abdominal computed tomography showed that the wall of the antrum was thickened and enhanced (arrow); C: Barium meal examination showed filling defect at the antrum and stenosis of the lumen.
Figure 2
Figure 2
Hematoxylin-eosin histopathological examination of the surgically resected specimen. A: A well-differentiated adenocarcinoma was revealed, coexisting with pancreatic heterotopia composed of ducts (×100); B: High-power view of duct-like structures of adenocarcinoma (×400); C: Invasion of bundles of nerves was seen (arrow) (×200).
Figure 3
Figure 3
Immunohistochemical staining. A: Cytokeratin 7 (×200); B: Carcinoembryonic antigen (×200); C: CDX-2 (×400); D: Cytokeratin 20 (×200).
See this image and copyright information in PMC

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