Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 7, 2015; 21(25): 7916-7920
Published online Jul 7, 2015. doi: 10.3748/wjg.v21.i25.7916
Intraductal papillary mucinous neoplasm of the ileal heterotopic pancreas in a patient with hereditary non-polyposis colorectal cancer: A case report
Sang Hwa Lee, Wook Youn Kim, Dae-Yong Hwang, Hye Seung Han
Sang Hwa Lee, Wook Youn Kim, Hye Seung Han, Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, South Korea
Dae-Yong Hwang, Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, South Korea
Author contributions: Lee SH analyzed the data and wrote the paper; Lee SH, Kim WY and Han HS made the pathologic diagnosis and reviewed the manuscript; and Hwang DY performed surgery, clinical care of the patient and collected the patient’s clinical data.
Ethics approval: The study was reviewed and approved by the Konkuk University Medical Center Institutional Review Board.
Informed consent statement: A study participant provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have no conflicts of interest regarding this paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hye Seung Han, MD, PhD, Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro Hwayang-dong, Gwangjin-gu, Seoul 143-729, South Korea. aphsh@kuh.ac.kr
Telephone: +82-2-20305644 Fax: +82-2-20305629
Received: January 23, 2015
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
Abstract

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.

Keywords: Colorectal neoplasms, Hereditary nonpolyposis, Pancreatic neoplasms, Choristoma

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.