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Abstract
A case is presented with multiple sites of ectopic pancreatic tissue in the gastro-intestinal tract. The sites were found in the stomach and duodenum, one site of ectopic pancreatic tissue presented with necrotizing pancreatitis. Ectopic pancreatic tissue can be defined as all pancreatic tissue, with no anatomical or vascular continuity with the orthotopic pancreas. The ectopic tissue most likely originates from the spreading of cells, during the allocation of structures derived from the foregut in the embryonic phase. Over ninety percent of ectopic tissue presents in the upper gastrointestinal tract, although other locations have been described. To date this is the first case-report about a patient with multiple localizations of ectopic pancreatic tissue.
Highlights
Pancreatic tissue, with no anatomical or vascular continuity with the orthotopic pancreas, is described as aberrant pancreas or ectopic pancreatic tissue
Symptomatic patients often present with wide range of symptoms, such as abdominal pain, dysphagia and in rare complicated cases patients present with pancreatitis, pseudocysts, upper gastrointestinal bleeding or even adenocarcinoma of ectopic pancreatic tissue (Osanai et al 2001; Lee et al 2014)
Previous case-reports describe singular sites of ectopic pancreatic tissue, to our knowledge this is the first reported case of a patient presenting with multiple sites of symptomatic ectopic pancreatic tissue (Carvalho et al 2014; Filip et al 2014; Macedo et al 2014)
Summary
Pancreatic tissue, with no anatomical or vascular continuity with the orthotopic pancreas, is described as aberrant pancreas or ectopic pancreatic tissue. Multiple case reports depict different presentations of ectopic pancreatic tissue, describing only singular sites. During the examination a small mass with a central opening was visible in the antrum of the stomach These findings are consistent with ectopic pancreatic tissue with an accessory pancreatic duct. Two sited of ectopic pancreatic tissue were confirmed, one being the aberrant tissue with accessory duct in the antrum of the stomach, the second being the tumor in the fundus with necrotizing pancreatitis. Following these results, the tumor in the esophagus was studied with MRI under suspicion of a third site of ectopic pancreatic tissue. As all sites are asymptomatic, resection is not deemed indicated
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