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Updated: Jun 2, 2026

Robotic Duodenum-preserving Total Pancreatic Head Resection for Intraductal Papillary Mucinous Neoplasms
Published on: April 17, 2026
Heterotopic pancreatic neoplasm presenting as an obstructing mass at the fourth portion of the duodenum
Cameron Stock1, Xavier M Keutgen, David Pisapia
1Division of Minimally Invasive and Endocrine Surgery, Department of Surgery, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA.
Context:
Heterotopic pancreatic adenocarcinoma is a rare finding at laparotomy. Herein we present the case of a patient with malignant transformation of a heterotopic pancreas located in the fourth portion of the duodenum.
Case Report:
A 79-year-old woman was admitted to the surgery service with complaints of early satiety and abdominal fullness progressively worsening over the previous two years. A computed tomography scan of the abdomen and an upper endoscopy revealed an obstructing mass in the fourth portion of the duodenum, biopsies were negative for carcinoma. A segmentectomy of the third and fourth portions of the duodenum was performed. Post-operative histology revealed malignant transformation of a heterotopic pancreas. The patient had an unremarkable postoperative recovery and was discharged home.
Conclusion:
In evaluation of patients with distal duodenal masses, we report that heterotopic pancreatic neoplasms should be considered in the differential diagnosis.
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