Rapid growing mediastinal ectopic pancreas within ruptured thymic cyst treated using video-assisted thoracic surgery

Ectopic pancreas (EP) is typically found within other gastrointestinal organs. Its discovery in other parts of the body, especially in the mediastinum, is exceedingly rare. This paper presents a case of a 17-year-old female patient with EP in a large, rapidly growing thymic cyst. She presented to our institution with persistent chest pain. Video-assisted thoracic surgery revealed a mediastinal mass in the setting of pleural effusion. Analysis of the fluid contents of the mass and the pleural effusion demonstrated high levels of pancreatic amylase, which supported the presence of pancreatic tissue within the mass. This is the first reported case of EP in a thymic cyst with an active pancreatic exocrine function. It is also the first reported case of mediastinal EP rupture secondary to autodigestion by amylase.