Case Report
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World J Gastroenterol. Mar 21, 2006; 12(11): 1786-1787
Published online Mar 21, 2006. doi: 10.3748/wjg.v12.i11.1786
Complete pancreatic heterotopia of gallbladder with hypertrophic duct simulating an adenomyoma
Luca Pilloni, Alessandro Cois, Alessandro Uccheddu, Rossano Ambu, Pierpaolo Coni, Gavino Faa
Luca Pilloni, Rossano Ambu, Pierpaolo Coni, Gavino Faa, Istituto di Anatomia Patologica, Dipartimento di Citomorfologia, Università degli Studi di Cagliari, Italy
Alessandro Cois, Alessandro Uccheddu, Semeiotica Chirurgica, Dipartimento Chirurgico Materno Infantile e di Scienze delle Immagini, Università degli Studi di Cagliari, Italy
Correspondence to: Dr. Pilloni Luca, Istituto di Anatomia Patologica, Dipartimento di Citomorfologia, Università degli Studi di Cagliari, Via Ospedale 46, Cagliari 09124, Italy. lucpilloni@tiscali.it
Telephone: +39-70-6092371 Fax: +39-70-657882
Received: July 20, 2005
Revised: July 29, 2005
Accepted: August 3, 2005
Published online: March 21, 2006
Abstract

The gallbladder is an unusual location of pancreatic heterotopia, defined as the presence of pancreatic tissue lacking anatomical and vascular continuity with the main body of the gland. A 28-year-old man presented with anorexia, nausea and pain in the right upper abdomen. On physical examination, the abdomen was tender to palpation and Murphy sign was positive. The patient underwent a cholecystecomy. This case, in our opinion, is very interesting since it permits to consider a controversial issue in the pathology of the gallbladder. The histological appearance of ductal structure in pancreatic heterotopia resembles the histological picture of both Aschoff-Rokitansky (AR) sinuses and adenomyomas. This finding suggests that these lesions are linked by a common histogenetic origin. We suggest that the finding of an adenomyoma in the gallbladder should prompt an extensive sampling of the organ in order to verify the coexistence of pancreatic rests.

Keywords: Pancreatic heterotopia; Gallbladder; Hypertrophic duct; Adenomyoma; Aschoff-Rokitansky sinuses