Intramural ectopic pancreatic tissue of the stomach: A case report of an uncommon origin of a non-cancerous gastric tumour

Highlights

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  Ectopic pancreatic tissue is a rare incidental finding during abdominal surgery.

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  80% of the lesions are unifocal and less than 3 cm in size.

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  The most frequent site is the stomach, followed by duodenum and proximal jejunum.

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  The imaging modalities and endoscopic biopsy often remain inconclusive.

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  Only resection and and histopathologic examination provide the definitve diagnosis.

Abstract

Introduction

Ectopic pancreatic tissue is often incidentally encountered during abdominal surgery. We report a case of an incidental finding during a laparoscopic appendectomy, the approach to diagnosis and management of this.

The work has been reported in line with the SCARE criteria.

Presentation of case

A 32 year-old woman was diagnosed with an intramural pre-pyloric mass during a laparoscopic appendectomy. The lesion was identified on a subsequent computed tomography as a homogenous mass on the greater curvature. Upper esophagho-gastro-duodenoscopy was normal. The intramural mass was confirmed by an endoscopic sonography and the fine needle biopsy showed aspecific inflammatory cells. A laparoscopic wedge resection was realized. Histopathologic examination confirmed the diagnosis of an ectopic pancreatic tissue.

Discussion

The management of ectopic pancreas poses a medical challenge. The diagnostic quiver consists of radiologic exams and endoscopy, in combination with a direct biopsy of the lesion.

Conclusion

Despite the plethora of diagnostic modalities available, a definitive diagnosis for heterotopic pancreas often remains elusive, requiring more invasive diagnostic means. Although ample information is available in literature, there are currently no evidence-based guidelines regarding diagnosis and management of heterotopic pancreas.