Esophageal heterotopic pancreas presenting as an inflammatory mass

A 47-year-old female presented with complaints of epigastric pain, poor appetite, and dysphagia. Abdominal CT and esophagogastroduodenoscopy revealed a 9-cm mass extrinsic to the distal esophagus. Esophagogastrectomy was performed. The distal esophagus contained multiple foci of heterotopic pancreatic tissue. There was associated inflammation and fat necrosis in the surrounding periesophageal soft tissue. Heterotopic pancreas is uncommon in the esophagus, with only a few reports appearing in the English literature. The clinical features of heterotopic pancreas, and the pathophysiology of the associated inflammatory lesion is discussed.