Pancreatic somatostatinoma and tuberous sclerosis: case report of an exceedingly rare association

Abstract

smooth muscle. A common blood supply should be present. It should be lined by alimentary-tract epithelium. Rarely, respiratory-tract epithelium, in conjunction with alimentary-tract epithelium, has been noted. In adults, diagnosis is very difficult before surgery. Gastric duplication cysts are usually asymptomatic. However, signs and symptoms may include epigastric pain, abdominal mass, or vomiting. Rarely, GI bleeding, pancreatitis, peritonitis, malignancy, or even acute abdomen may result. Often, a GDC may be mistaken as a pancreatic pseudocyst, which is more common. Normal levels of pancreatic enzymes and no personal history of pancreatitis may suggest a gastric duplication cyst. Unlike GDC, the pancreatic pseudocyst is generally associated with repeated attacks of pancreatitis. They lack an epithelial lining and contain amylase-rich fluid. US, CT, and EUS may help in the diagnosis. In our case, the diagnosis was made before surgery by EUS-guided cyst aspiration and ERP. Surgical resection led to a satisfactory outcome. This case provides a fascinating opportunity to explore embryogenesis of the alimentary tract, as well as highlighting the usefulness of EUS and ERP in preoperative diagnosis.