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Gastric Ectopic Pancreas Manifested As a Subepithelial Tumor: Three Case Reports and an Overview

Yen-Chun Chen, Hoi-Hung Chan, Kwok-Hung Lai, Tzung-Jiun Tsai, Ping-I Hsu

Context Heterotopic pancreas can be seen along the alimentary tract. Gastric heterotopic pancreas may be asymptomatic or symptomatic. Symptoms are often nonspecific. The presentation is associated with the location, size and depth of that ectopic tissue. Possible complications include ulcer bleeding, obstruction, intussusceptions, pancreatitis or even malignancy. To treat asymptomatic patients is still debatable. It is reasonable to treat symptomatic patients. Case report We reported three patients who presented with epigastric discomforts. Gastrointestinal stromal tumors were diagnosed after the initial work-up. However, pathology following surgical resection showed ectopic pancreas. Conclusion The endoscopic pictures of ectopic pancreas may mimic subepithelial tumors so the accurate diagnosis requires multi-modalities, such as computed tomography/magnetic resonance imaging, Endoscopic ultrasound and Endoscopic ultrasound - fineneedle aspiration. Sometimes the diagnosis is made by the pathology result after surgical resection. If treatment is indicated, the options include laparoscopic resection, electronic medical record or electrostatic discharge.