Pancreatic Heterotopia: A Study of Five Cases

A Khadhar, S Ben Slama, A Lahmar, F Limaiem, S Bouraoui, M Ben Ammar, S Mzabi-Regaya

Abstract


The purpose of this study is to provide an updated overview on the pathogenesis, manifestations, pathology, imaging, and treatment of different heterotopic pancreas (HP).
Over an 8 year period (2003 - 2010), five cases of HP involving different organs were diagnosed at the pathology department. Relevant clinical information and microscopic slides were available and were reviewed.
Our study included 3 male and 2 female patients aged between 23 and 72 years. In our series, HP involved the ileum (n=2), the ampulla of vater (n=1), the gallbladder neck (n=1) and the gastric antrum (n=1). Our patients were admitted for: liver transplantation for autoimmune hepatitis (n=1), jaundice (n=1) and abdominal pain (n=3). Imaging studies did not make preoperative diagnosis of HP in any case. Histopathological examination established the diagnosis of isolated HP in 2 cases, HP associated with ductal pancreatic adenocarcinoma in 2 cases and HP with cirrhosis of the liver in 1 case.
HP is usually asymptomatic and its pre-operative diagnosis is difficult to make primarily due to non-specific clinical and radiological features. Although malignant transformation is rare, an observation with periodic endoscopic evaluation is recommended for asymptomatic patients.

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