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Adenocarcinoma arising in gastric heterotopic pancreas: a case report.

Song DE, Kwon Y, Kim KR, Oh ST, Kim JS - J. Korean Med. Sci. (2004)

Bottom Line: A heterotopic pancreas in the gastrointestinal tract is mostly found incidentally and its malignant transformation is extremely rare.Microscopically, the cystic portion was composed of dilated pancreaticobiliary type ducts with adjacent small foci of periductal glandular structures.The follow-up course was uneventful 5 months postoperatively.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Korea.

ABSTRACT
A heterotopic pancreas in the gastrointestinal tract is mostly found incidentally and its malignant transformation is extremely rare. We describe the second case of adenocarcinoma arising in a gastric heterotopic pancreas of an asymptomatic 35-yr-old man in Korea. Esophagogastroduodenoscopy revealed a submucosal tumor with an irregular central umbilication in the gastric antrum. A wedge resection specimen demonstrated a submucosal oligolocular cystic mass (1.7 x 1.4 x 1.2 cm) with a solid portion. Microscopically, the cystic portion was composed of dilated pancreaticobiliary type ducts with adjacent small foci of periductal glandular structures. The adenocarcinoma components in the solid area infiltrated the proper muscle and the overlying mucosa of the stomach. The transitional area between the benign ductal structures and the adenocarcinoma component was found. The follow-up course was uneventful 5 months postoperatively.

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The abdominal CT reveals a well-demarcated multiseptate cystic mass (arrows) in the gastric antrum.
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Figure 2: The abdominal CT reveals a well-demarcated multiseptate cystic mass (arrows) in the gastric antrum.

Mentions: A 35-yr-old man who had been healthy underwent a routine medical check-up. On esophagogastroduodenoscopy (EGD), a submucosal mass with an irregular central umbilication was found in the gastric antrum (Fig. 1). The physical examination and all the laboratory findings were normal. The tumor markers including CEA (2.7 ng/mL), CA-19-9 (6.9 u/mL) and CA-72-4 (3.1 u/mL) were within normal ranges. Abdominal CT scan revealed a well-demarcated multiseptate cystic mass in the gastric antrum (Fig. 2). A wedge resection was performed under the clinical impression of gastrointestinal stromal tumor.


Adenocarcinoma arising in gastric heterotopic pancreas: a case report.

Song DE, Kwon Y, Kim KR, Oh ST, Kim JS - J. Korean Med. Sci. (2004)

The abdominal CT reveals a well-demarcated multiseptate cystic mass (arrows) in the gastric antrum.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2822253&req=5

Figure 2: The abdominal CT reveals a well-demarcated multiseptate cystic mass (arrows) in the gastric antrum.
Mentions: A 35-yr-old man who had been healthy underwent a routine medical check-up. On esophagogastroduodenoscopy (EGD), a submucosal mass with an irregular central umbilication was found in the gastric antrum (Fig. 1). The physical examination and all the laboratory findings were normal. The tumor markers including CEA (2.7 ng/mL), CA-19-9 (6.9 u/mL) and CA-72-4 (3.1 u/mL) were within normal ranges. Abdominal CT scan revealed a well-demarcated multiseptate cystic mass in the gastric antrum (Fig. 2). A wedge resection was performed under the clinical impression of gastrointestinal stromal tumor.

Bottom Line: A heterotopic pancreas in the gastrointestinal tract is mostly found incidentally and its malignant transformation is extremely rare.Microscopically, the cystic portion was composed of dilated pancreaticobiliary type ducts with adjacent small foci of periductal glandular structures.The follow-up course was uneventful 5 months postoperatively.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Korea.

ABSTRACT
A heterotopic pancreas in the gastrointestinal tract is mostly found incidentally and its malignant transformation is extremely rare. We describe the second case of adenocarcinoma arising in a gastric heterotopic pancreas of an asymptomatic 35-yr-old man in Korea. Esophagogastroduodenoscopy revealed a submucosal tumor with an irregular central umbilication in the gastric antrum. A wedge resection specimen demonstrated a submucosal oligolocular cystic mass (1.7 x 1.4 x 1.2 cm) with a solid portion. Microscopically, the cystic portion was composed of dilated pancreaticobiliary type ducts with adjacent small foci of periductal glandular structures. The adenocarcinoma components in the solid area infiltrated the proper muscle and the overlying mucosa of the stomach. The transitional area between the benign ductal structures and the adenocarcinoma component was found. The follow-up course was uneventful 5 months postoperatively.

Show MeSH
Related in: MedlinePlus