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Foregut choristoma of the ileum, (adenomyoma)--a case report
1Department of Pediatric Pathology, Seoul National University Children's Hospital, Korea.
Insights
A rare ileal adenomyoma causing intussusception in a child is presented. The authors propose "foregut choristoma" for this and similar gastrointestinal heterotopic conditions.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Surgical Pathology
Background:
- Adenomyomas are benign tumors typically found in the uterus.
- Gastrointestinal adenomyomas are rare, with most reported cases in the stomach's antrum.
- Intussusception is a condition where one part of the intestine slides into another.
Observation:
- A 7-year-old boy presented with symptoms of jejunoileal intussusception.
- Imaging and surgical exploration revealed a polypoid mass in the ileum.
- The mass was histologically identified as an adenomyoma.
Findings:
- The ileal adenomyoma exhibited features distinct from typical uterine adenomyomas.
- Histological analysis showed cystic glandular structures lined by hepatobiliary/pancreatic-like epithelium and smooth muscle bundles.
- This unique presentation prompted the proposal of a new term for such lesions.
Implications:
- The term "foregut choristoma" is proposed to encompass ileal adenomyomas and other ectopic tissues like pancreas or Brunner's glands in the GI tract.
- This classification may aid in understanding the developmental origins and clinical management of these rare entities.
- Further research is needed to delineate the full spectrum and clinical significance of foregut choristomas.
Abstract:
An ileal adenomyoma in a 7-year-old boy who presented with jejunoileal intussusception is described and the term "foregut choristoma" is proposed for this and related conditions, such as ectopic pancreas or heterotopic Brunner's glands in the gastrointestinal tract. The polypoid mass in the ileum of this patient was composed of cystically dilated glandular structures lined by a tall columnar epithelium resembling hepatobiliary or pancreatic ductal epithelium, hypertrophic and irregular smooth muscle bundles surrounding the glandular elements, and small amount of fibrous stroma. Reported cases of this disorder in the gastrointestinal tract are generally confined to the antrum of the stomach.