Gastric fundal heterotopic pancreas mimicking a gastrointestinal stromal tumour (GIST): a case report and a brief review

Subasinghe, Duminda; Sivaganesh, Sivasuriya; Perera, Niranthi; Samarasekera, Dharmabandhu Nandadeva

doi:10.1186/s13104-016-1995-5

Cited by 17 publications

(17 citation statements)

References 16 publications

(19 reference statements)

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“…Although gastroscopic biopsy is regarded as the gold standard for the diagnosis of tumors, limitations include its invasive nature, sampling errors, diagnostic errors, long waiting times for immunohistochemistry results [ 9 ], and powerless assessing situations outside the tumor. Computed tomography (CT), as a common imaging examination method, has been used in the preoperative evaluation of submucosal tumors, and can be used as a supplemental tool in differentiating HP masses from STs [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Although many studies have been conducted on the imaging features of HP masses and gastric stromal tumors (STs), most have employed endoscopic ultrasonography [ 11 , 12 ], with few adopting CT characteristics, and most have been case reports [ 10 , 13 ]. To our knowledge, no studies have reported CT findings for differentiating gastric submucosal tumors less than 3 cm in diameter.…”

Section: Introductionmentioning

confidence: 99%

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Gastric heterotopic pancreas and stromal tumors smaller than 3 cm in diameter: clinical and computed tomography findings

Feng

Chen

et al. 2018

Cancer Imaging

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BackgroundIdentifying gastric heterotopic pancreas and stromal tumors is difficult. Few studies have reported computed tomography (CT) findings for differentiating lesions less than 3 cm in diameter. In this study, we aimed to identify clinical characteristics and CT findings that can differentiate gastric heterotopic pancreatic lesions from stromal tumors less than 3 cm in diameter.MethodsA total of 132 patients with pathologically confirmed gastric heterotopic pancreas (n = 66) and stromal tumors (n = 66) were included. Each group was divided into primary (n = 50) and validation cohort (n = 16). Clinical characteristics and CT findings were retrospectively reviewed. CT findings included location, border, contour, growth pattern, enhancement pattern and grade, the enhancement value of tumor, enhancement ratio of tumor, and enhancement ratio of tumor to pancreas in venous phase. The findings in the two groups were compared using the Pearson χ2 test or Student t-test. Receiver operating characteristic curves were used to determine areas under the curve and optimal cut-offs.ResultsSignificant differences were observed between heterotopic pancreas and stromal tumors in the distribution of tumor location, border, contour (all P < 0.001), enhancement values (P < 0.001), enhancement ratios of tumors (P < 0.001), and enhancement ratios of tumors to pancreas (P < 0.001). No significant differences existed in growth pattern (P = 0.203). The area under the curve differed significantly between enhancement ratio of tumor to pancreas and enhancement ratio (P = 0.030). There were significant differences in above characteristics between two groups in validation cohort.ConclusionsHeterotopic pancreas has characteristic CT features differentiating it from stromal tumors.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Gastric heterotopic pancreas and stromal tumors smaller than 3 cm in diameter: clinical and computed tomography findings

Feng

Chen

et al. 2018

Cancer Imaging

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“…The incidence range is reported to be between 0.5% and 13.7% of autopsies [2]. The most common location along the gastrointestinal tract (GIT) is the stomach (38%) and the small bowel [9]. If symptomatic, patients present with pancreatitis, pain, bleeding, obstruction, or malignancy.…”

Section: Discussionmentioning

confidence: 99%

Unexpected Gastric Ectopic Pancreas During Sleeve Gastrectomy: A Case Report

et al. 2019

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Objective: Rare disease Background: Ectopic or heterotopic pancreas is relatively rare pathology described as pancreatic tissue lacking communication with the normal pancreas. Ectopic pancreatic tissue can be found along the gastrointestinal tract, with the most common location the stomach along the greater curvature. This congenital condition could be identified incidentally, or present with symptoms that range from pain and bleeding to obstruction and malignant transformation. Case Report: We report a case of a 30-year-old female, who underwent laparoscopic sleeve gastrectomy for morbid obesity of body mass index (BMI) of 46 kg/m 2 , and who was found to have a 3 cm submucosal mass at the lesser curvature while dividing the stomach. The sleeved stomach tube's intraoperative gastroscopy showed a submucosal mass at the posterior stomach wall towards the lesser curvature, increasing the suspicion of gastrointestinal stromal tumor (GIST) tumor. The choice was to continue with a secure margin and conversion to roux-en-y gastric bypass with gastric tumor resection. It turned out that the final pathology was submucosal ectopic pancreas. Despite being a rare pathology, for any submucosal gastric mass, ectopic pancreas should be on the differential diagnosis list. During the sleeve surgery, the mass was found, and the approach was changed to intraoperatively subtotal gastrectomy and roux-en-y gastric bypass. Conclusions: Before any bariatric operation, even in asymptomatic young patients, it is worth doing routine upper endoscopy to prevent surprising intraoperative pathology.

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“…Although heterotopic pancreas can present at any age, it is usually discovered in the fifth and sixth decade, and is three times more likely to occur in men than women (4). When gastric, the heterotopic tissue is located in over 50% of the cases within 5 cm of the pylorus.…”

Section: Discussionmentioning

confidence: 99%

Heterotopic pancreatic tissue of the stomach leading to gastric diverticulum and upper gastro-intestinal bleeding

Stoian¹,

Pop²,

Strâmbu³

2016

J Clin Invest Surg.

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Heterotopic pancreatic tissue of the stomach is a rare condition. Gastric diverticulum is also a rare condition, mostly located at the fornix. Therefore, the existence of a pyloric gastric diverticulum containing a submucosal tumor proved to be heterotopic pancreatic tissue of the stomach is an extremely rare condition.The patient was a young thin male with epigastralgia chronically treated for gastritis/ulcer.Following an episode of melena, he underwent gastroscopy that diagnosed antral gastric diverticulum containing a polyp. The lesion was surgically removed.The pathology report stated: heterotopic pancreatic tissue of the stomach with secondary development of a traction diverticulum.Heterotopic pancreas tissue of the stomach is a rare condition but the association with gastric diverticulum is completely unusual. The possibility of the ectopic tissue leading to secondary diverticulum development should be considered.Acne conglobata is a rare, severe form of acne vulgaris characterized by the presence of comedones, papules, pustules, nodules and sometimes hematic or meliceric crusts, located on the face, trunk, neck, arms and buttocks.

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Gastric fundal heterotopic pancreas mimicking a gastrointestinal stromal tumour (GIST): a case report and a brief review

Cited by 17 publications

References 16 publications

Gastric heterotopic pancreas and stromal tumors smaller than 3 cm in diameter: clinical and computed tomography findings

Gastric heterotopic pancreas and stromal tumors smaller than 3 cm in diameter: clinical and computed tomography findings

Unexpected Gastric Ectopic Pancreas During Sleeve Gastrectomy: A Case Report

Heterotopic pancreatic tissue of the stomach leading to gastric diverticulum and upper gastro-intestinal bleeding

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