Case Report
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Mar 14, 2010; 16(10): 1293-1295
Published online Mar 14, 2010. doi: 10.3748/wjg.v16.i10.1293
Malignant transformation of ectopic pancreatic cells in the duodenal wall
Roberto Bini, Paolo Voghera, Alberto Tapparo, Raffaele Nunziata, Andrea Demarchi, Matteo Capocefalo, Renzo Leli
Roberto Bini, Paolo Voghera, Alberto Tapparo, Renzo Leli, Department of General and Emergency Surgery, San Giovanni Bosco Hospital, 10154 Turin, Italy
Raffaele Nunziata, Andrea Demarchi, Department of Pathology, San Giovanni Bosco Hospital, 10154 Turin, Italy
Matteo Capocefalo, Department of Microbiology and Biochemistry, The University of Leeds, Leeds LS2 9JT, United Kingdom
Author contributions: Bini R and Leli R contributed equally to this work; Bini R, Voghera P, Tapparo A and Leli R designed the research; Nunziata R and Demarchi A performed the research and contributed new reagents/analytic tools; Voghera P, Tapparo A and Capocefalo M analyzed the data; Bini R and Capocefalo M wrote the paper.
Supported by National Health Service
Correspondence to: Dr. Roberto Bini, MD, Department of General and Emergency Surgery, San Giovanni Bosco Hospital, 10154 Turin, Italy. re.bini@libero.it
Telephone: +39-347-3592421 Fax: +39-11-2402872
Received: November 1, 2009
Revised: January 17, 2010
Accepted: January 24, 2010
Published online: March 14, 2010
Abstract

Ectopic pancreas (EP) is the relatively uncommon presence of pancreatic tissue outside the normal location of the pancreas. This condition is usually asymptomatic and rarely complicated by pancreatitis and malignant transformation. A few cases of neoplastic phenomena that developed from EP into the duodenal wall are described in the literature. Herein we report a case of gastric outlet obstruction due to adenocarcinoma arising from EP of the duodenal wall. The patient underwent a Whipple’s procedure and had an uneventful post-operative recovery. Traditional imaging studies are often inconclusive in the definitive diagnosis, whilst endoscopic ultrasonography and guided biopsy may aid accurate pre-operative diagnosis. Diagnostic uncertainty warrants surgical exploration and if necessary extended resection is indicated.

Keywords: Ectopic pancreas, Duodenum, Gastrointestinal obstruction, Neoplasm, Pancreaticoduodenectomy