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Published on: November 1, 2021
Ectopic pancreatic tissue mimicking ampullary tumor
Prasad K Wagle1, Guruprasad S Shetty, Mridula Sampat
1Department of GI Services, Lilavati Hospital and Research Center, Mumbai, India. drpkw@vsnl.com
Summary
Ectopic pancreas, a rare anomaly, was found in the ampulla of a 70-year-old woman presenting with obstructive jaundice. Initial suspicion of malignancy was disproven by histology revealing only ectopic pancreatic tissue.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Anatomical Anomalies
Background:
- Ectopic pancreas is a congenital anomaly resulting from abnormal fusion of embryonic pancreatic buds.
- These aberrant pancreatic tissues can occur throughout the gastrointestinal tract, most commonly in the stomach, duodenum, and jejunum.
- Ampullary location is exceptionally rare, posing diagnostic challenges.
Observation:
- A 70-year-old female patient presented with symptoms of obstructive jaundice.
- Imaging and clinical evaluation suggested an ampullary malignancy.
- The patient underwent a pancreaticoduodenectomy (Whipple procedure) for suspected cancer.
Findings:
- Post-operative histological examination revealed ectopic pancreatic tissue within the ampulla of Vater.
- The ampullary mass was confirmed to be benign ectopic pancreatic tissue, not a malignancy.
- This finding highlights the importance of thorough histopathological analysis in differentiating rare anomalies from neoplastic processes.
Implications:
- This case underscores the potential for ectopic pancreatic tissue to mimic malignant ampullary tumors, leading to unnecessary aggressive surgical intervention.
- Accurate diagnosis of ectopic pancreas is crucial for appropriate patient management and avoiding overtreatment.
- Further research into the specific embryological factors leading to ampullary ectopic pancreas may improve diagnostic accuracy.
