A Case of Heterotopic Pancreas within the Gastric Proper Muscle Layer

Heo, Seoung Sik; Yook, Eun Ju; Im, Euyi Hyeog; Sung, Ja Won; Kim, Byeong Ho; Lee, Ki Cheon; Jeong, Hyun Yong; Lee, Heon Young; Kim, Young Kun

Abstract

Heteratopic or ectopic pancreas is found in 0.5% to 13% autopsy series and also found one in approximately every 500 operations in abdominal surgery. The mast common sites are stomach (esp, greater curvature of the antrum), duodenum and proximal jejunum. Many ar most of these lesions do not cause clinical symptoms and the symptoms with heterotopie pancreas are nonspecific. When it produces complication(hemorrhage, pancreatitis, pyloric or CBD obstruction, pseudocyst, cancer etc.), the symytoms depend on the site of lesion, the size of mass, and the primary pathologic processes occurring within the heterotopic pancreatic tissue. Gaetrofiberoscopy revealed a small round, submucosal projection with a central niche or umblication, but this characteristic umbilication is not always present. The lesions are frequently confused with polyp, leiomyoma, intramural neoplasm, gastric ulcer and early gastric cancer, The tumors are predominantly intramural masses; 75 percent are submuicosal and the others are either intrsmuscular or subserosal. We have recently experienced a case of heterotopic pancreas on the antrum of greater curvature of stomach in 54-year-old man, who visited our hospital for melena. Gastrofiberoscopy revealed a 2 x 2 cm sized submucosal mass without bleeding focus and local excision was performed. Histologic finding showed a pancreatic acini within the gastric poper muscle layer.