Atypical presentations of ectopic pancreatic tissue

Abstract

Ectopic pancreatic tissue (EPT) in a Meckel diverticulum is a well-known anomaly. Other locations are rare, especially in pediatric patients. We report on three children with incidental findings of EPT and reviewed the literature. Three children with incidental findings of EPT treated in our department, and 62 patients found in the literature were analyzed. The literature search was performed excluding EPT in Meckel's diverticulum and in tumors, i.e. teratomas. Two of our patients presented with an umbilical mass. The third patient presented with a gastric outlet obstruction due to an antral/pyloric mass. Histopathology showed EPT in all three of our patients without any signs of malignancy. In the literature, patients with EPT often appear to be asymptomatic. Symptomatic patients may present with bowel obstruction or intussusception. EPT in the umbilicus frequently seems to cause umbilical discharge. Our analysis supported the leading opinion in the literature that the upper gastrointestinal tract and especially the gastric antrum must be considered the most common location of EPT. Although unusual in children, awareness of EPT may help to obtain the proper diagnosis faster and to plan accurate surgical therapy. Prognosis study, Level IV.