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Pancreatic Heterotopia Found in the Gastric Antrum Mistaken for Malignancy
Rani Berry1, Harman K Rahal1, Wendy Ho2
1Department of Internal Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA.
Abstract:
Pancreatic heterotopia is a rare and often incidental finding in clinical practice. The term refers to pancreatic tissue distinct from the normal pancreas and with its own ductal and vascular supply. Usually asymptomatic, ectopic tissue is still prone to infection and may cause clinical complications when mistaken for malignancy or abscess. We describe a 32-year-old woman who presented with epigastric discomfort, initially thought to be a gastric outlet mass concerning for gastric malignancy vs an intraabdominal infection. She was eventually found to have an umbilicated submucosal lesion in the gastric antrum consistent with pancreatic heterotopia. Given the young age and sex of the patient, the differential diagnosis remained broad, underscoring the high risk of mismanagement of pancreatic heterotopia secondary to infrequency of this condition as a presenting diagnosis.
Insights
Pancreatic heterotopia, or ectopic pancreatic tissue, is a rare condition. This case highlights the diagnostic challenges and potential for mismanagement due to its infrequent presentation, even in young patients.
Area of Science:
- Gastroenterology
- Pathology
- Surgical Oncology
Background:
- Pancreatic heterotopia involves ectopic pancreatic tissue with its own blood supply, distinct from the main pancreas.
- While often asymptomatic, it can lead to complications like infection or be misdiagnosed as malignancy or abscess.
Observation:
- A 32-year-old woman presented with epigastric discomfort, initially suspected to be a gastric outlet mass or intraabdominal infection.
- Imaging revealed an umbilicated submucosal lesion in the gastric antrum.
Findings:
- The gastric antrum lesion was diagnosed as pancreatic heterotopia.
- The patient's young age and sex broadened the initial differential diagnosis.
Implications:
- The infrequency of pancreatic heterotopia as a presenting diagnosis poses a significant risk of clinical mismanagement.
- Accurate and timely diagnosis is crucial to avoid unnecessary interventions and ensure appropriate patient care.
