Abstract
BackgroundThe 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 presentationAn 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.ConclusionsAdenocarcinoma that arises from an ectopic pancreas should be considered when an obstruction is identified in the duodenum.
Highlights
The malignant transformation of an ectopic pancreas in the duodenum is extremely rare
Adenocarcinoma that arises from an ectopic pancreas should be considered when an obstruction is identified in the duodenum
In malignant transformations that arise from ectopic pancreatic tissue, gastrointestinal symptoms due to stenosis are easier to identify than in ordinary pancreatic cancer, which may result in a better prognosis in the former
Summary
Often found during surgery or biopsy, is defined as an uncommon pancreatic tissue outside the normal pancreas, which lacks any connection to the normal pancreas, and has its own vascular and ductal systems [1]. The tumor was 30 × 10 mm and located in the first part of the duodenum (Fig. 4) It was not continuous with the normal pancreas as revealed first by imaging and later confirmed during surgery. Normal pancreatic tissue was observed adjacent to the tumor, suggesting the presence of an ectopic pancreas (Fig. 5). The islets of the ectopic pancreas and the normal pancreas showed positive staining for chromogranin A, synaptophysin, neural cell adhesion molecule (NCAM), insulin, glucagon, and somatostatin. Based on these findings, our final diagnosis was of a ductal adenocarcinoma arising from an ectopic pancreas in the first part of the duodenum. The patient is alive without relapse, at 18 months of follow-up
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