Abdominal heterotopic tissues: review of 24 cases diagnosed on postoperative histological evaluation

Heterotopy is defined as abnormal localization of well-differentiated tissue. Heterotopic tissues usually tend to be asymptomatic and noncomplicated but sometimes may cause serious clinical problems. Malignancy potential is the most important issue in this clinical entity. In this study we reviewed medical records of 24 patients with heterotopic tissues.

Between 1995-2004, 24 patients with heterotopic tissues who were diagnosed during gastrointestinal system or abdominal wall surgery or upper gastrointestinal endoscopy were included in this study. Patients' medical data were retrospectively reviewed.

Sixteen patients with heterotopy were younger than 30 years and eight patients were older than 30 years. Nineteen (0.21%) heterotopic tissues were diagnosed in 8,945 patients who underwent gastrointestinal system surgery or upper gastrointestinal endoscopy, whereas five (0.21%) heterotopic tissues were diagnosed in 2,320 patients who underwent abdominal wall surgery. Overall, 24 (0.21%) heterotopic tissues were found in a total of 11,265 patients. The majority were pancreatic heterotopy, followed in decreasing order by gastric, adrenal and osseous heterotopy. In patients who underwent gastrointestinal surgery-endoscopy, pain was the main symptom (n=13)(68.4%), followed by dyspepsia (n=3)(15.7%) and vomiting- nausea (n=2)(10.5%). The main symptom in patients who underwent abdominal wall surgery was palpable mass. heterotopic tissues presented as wall thickening in 13, polypoid mass in five and whole solitary mass or intraparenchymal lesion in six patients.

Although incidence of heterotopic tissues is low, in case of its suspicion or diagnosis, early treatment should be performed by surgical or endoscopic resection or patients must be followed up carefully due to risk of malignancy.