Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2015; 21(13): 4082-4088
Published online Apr 7, 2015. doi: 10.3748/wjg.v21.i13.4082
Adenocarcinoma arising from heterotopic pancreas at the third portion of the duodenum
Nobutada Fukino, Takatsugu Oida, Kenji Mimatsu, Youichi Kuboi, Kazutoshi Kida
Nobutada Fukino, Takatsugu Oida, Kenji Mimatsu, Youichi Kuboi, Kazutoshi Kida, Department of Surgery, Japan Community Healthcare Organization Yokohama Central Hospital, Kanagawa 231-8553, Japan
Takatsugu Oida, Department of General Surgical Science, Nihon University Hospital, Tokyo 101-8309, Japan
Author contributions: Fukino N, Oida T, Mimatsu K, Kuboi Y and Kita K carried out the operation and were consultants overseeing the patient’s care; and Fukino N wrote the manuscript.
Ethics approval: The study was reviewed and approved by the Japan Community Healthcare Organization Yokohama Central Hospital ethical committee.
Informed consent: Because a patient dies, the written consent is impossible.
Conflict-of-interest: There is no Acts of conflict of interest.
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: Nobutada Fukino, MD, Department of Surgery, Japan Community Healthcare Organization Yokohama Central Hospital, 268 Yamashitachou, Naka-ku, Yokohama, Kanagawa 231-8553, Japan. fukino.nobutada@yokochu.jp
Telephone: +81-45-6411921 Fax: +81-45-6719872
Received: September 7, 2014
Peer-review started: September 18, 2014
First decision: September 27, 2014
Revised: November 18, 2014
Accepted: January 8, 2015
Article in press: January 8, 2015
Published online: April 7, 2015
Processing time: 212 Days and 4 Hours
Abstract

A 62-year-old Japanese man presented to our hospital with a history of weight loss of 6 kg in 4 mo. Imaging examinations revealed a tumor located on the third portion of the duodenum with stenosis. We suspected duodenal carcinoma and performed pancreas-preserving segmental duodenectomy. Adenocarcinoma arising from a heterotopic pancreas at the third portion of the duodenum was finally diagnosed by immunohistochemical staining. Malignant transformation in the duodenum arising from a heterotopic pancreas is extremely rare; to our knowledge, only 13 cases have been reported worldwide, including the present case. The most common location of malignancy is the proximal duodenum at the first and descending portion. Herein, we describe the first case of adenocarcinoma arising from a heterotopic pancreas, which was located in the third portion of the duodenum, with a review of the literature.

Keywords: Adenocarcinoma; Heterotopic pancreas; Duodenum; Segmental resection; Weight loss

Core tip: Based on all abdominal surgeries, the incidence of heterotopic pancreas ranges from 0.25% to 1.2%. The frequency of malignant transformation ranges from 0.7% to 1.8% among all heterotopic pancreas cases. Malignant transformation arising from a heterotopic pancreas is extremely rare. The most common location of malignancy is the proximal duodenum at the first and descending portion. In this paper, we report the case of a patient with weight loss who was diagnosed as having an adenocarcinoma arising from a heterotopic pancreas, at the third portion of the duodenum, with a review of the literature.