Heterotrophic Pancreatic Rest Mimicking Tumor in Stomach: A case Report and Literature Review
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 19, Issue 2
Abstract
Pancreatic tissue can be found outside its anatomic location and is often detected as an incidental finding. Most common location for such ectopic rests is gastrointestinal tract which may present with or without clinical symptoms. We present a case of young pregnant female having epigastric pain for couple of months and investigations show a large gastric growth, thought to be tumor initially. She underwent surgery and histopathology turned out to be heterotrophic pancreatic tissue.Pancreatic heterotopia is an entity defined by extra pancreatic tissue without any anatomic or vascular continuity with the pancreas. It can be seen in any part of the gastrointestinal tract with larger percentages found in stomach followed by small intestine. It may remain silent over period of years or present clinically mimicking symptoms of acid peptic disease, ulcer, upper gastrointestinal tract bleeding, obstruction and even malignant transformation occasionally. Radiological appearances are variable ranging from small lesion to large masses. Histopathological diagnosis remains the gold standard.A 26 year old female presented in outpatient clinic during her second trimester of pregnancy with complaints of daily regular epigastric pain with off and on vomiting. The pain started during pregnancy 2 months back. She never felt such pain before. No melena or hematemesis. Thinking of peptic ulcer she was given proton pump inhibitors which showed no response. Ultrasound abdomen performed was unremarkable. CT abdomen with oral and IV contrast was advised due to her persistent symptoms. Scan showed a large low attenutation soft tissue exophytic lesion with septations and cystic changes arising from the body and pylorus of stomach. No contrast enhancement noted. Considering its size and appearances probable diagnosis of gastrointestinal stromal tumor (GIST) was made (Figures 1- 3). Endoscopy done demonstrated sub mucosal origin of the lesion and hence biopsy was not taken. She was referred to surgery department where she had partial distal gastrectomy and gastrojejunal anastomotsis. Histopathology came out to be heterotrophic pancreatic rest rather than neoplastic lesion (Figures 4 & 5).
Authors and Affiliations
Waqas Ahmad, Jamshed Yousef, Tamer Marei, Maher Nasser, Mohamed Tahar Yacoubi
Keywords
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- EP ID EP620655
- DOI 10.26717/BJSTR.2019.19.003267
- Views 175
- Downloads 0
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