Published online Jul 7, 2015. doi: 10.3748/wjg.v21.i25.7916
Peer-review started: January 24, 2015
First decision: March 10, 2015
Revised: March 20, 2015
Accepted: April 16, 2015
Article in press: April 16, 2015
Published online: July 7, 2015
We report a case of intraductal papillary mucinous neoplasm (IPMN) originating from the ileal heterotopic pancreas in a patient with hereditary non-polyposis colorectal cancer (HNPCC). A 49-year-old woman had a past history of total colectomy and total hysterectomy with bilateral salpingo-oophorectomy due to colonic adenocarcinoma and endometrial adenocarcinoma 11 years ago. Her parents died from colonic adenocarcinoma and her sister died from colonic adenocarcinoma and endometrial adenocarcinoma. The clinician found an ileal mass with necrotic change and the mass increased in size from 1.7 cm to 2.2 cm during the past 2 years on computed tomography. It was surgically resected. Microscopically, the ileal mass showed heterotopic pancreas with IPMN high grade dysplasia. Immunohistochemical staining revealed positive reactivity for MLH1/PMS2 and negative reactivity for MSH2/MSH6. This is the first report of IPMN originating from the ileal heterotopic pancreas in a patient with HNPCC in the English literature.
Core tip: Intraductal papillary mucinous neoplasm (IPMN) is a precursor lesion of pancreatic cancer. Although pancreatic cancer is one of the malignancies associated with hereditary non-polyposis colorectal cancer (HNPCC), only one case has been reported IPMN in a HNPCC patient. We report a first case of IPMN arising in heterotopic pancreas in a patient of HNPCC.