Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clinical Cases. Sep 16, 2016; 4(9): 281-284
Published online Sep 16, 2016. doi: 10.12998/wjcc.v4.i9.281
Cystic jejunal duplication with Heinrich’s type I ectopic pancreas, incidentally discovered in a patient with pancreatic tail neoplasm
Simona Gurzu, Tivadar Bara Jr, Tivadar Bara, Annamaria Fetyko, Ioan Jung
Simona Gurzu, Annamaria Fetyko, Ioan Jung, Department of Pathology, University of Medicine and Pharmacy, 540139 Tirgu-Mures, Romania
Tivadar Bara Jr, Tivadar Bara, Department of Surgery, University of Medicine and Pharmacy, 540139 Tirgu-Mures, Romania
Author contributions: Gurzu S wrote the manuscript and carried out the study design; Bara Jr T participated at the surgical intervention and interpretation of clinical data; Bara T participated at the surgical intervention and interpretation of the data from literature; Fetyko A checked the English quality; Jung I contributed to the histological assessment of the surgical specimens and coordinated the study design and the draft of the manuscript.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at University of Medicine and Pharmacy, Tirgu-Mures, Romania.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
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: Simona Gurzu, MD, PhD, Professor, Head of Research Laboratory, Department of Pathology, University of Medicine and Pharmacy, 38 Ghe Marinescu Street, 540139 Tirgu Mures, Romania. simonagurzu@yahoo.com
Telephone: +40-74-5673550 Fax: +40-26-5210407
Received: April 29, 2016
Peer-review started: April 29, 2016
First decision: May 17, 2016
Revised: June 3, 2016
Accepted: July 11, 2016
Article in press: July 13, 2016
Published online: September 16, 2016
Processing time: 131 Days and 13.1 Hours
Abstract

The aim of this study was to present a case of enteric duplication cyst and criteria for a proper differential diagnosis. A 51-year-old male was hospitalized for pancreatic tail neoplasm and distal pancreatectomy with splenectomy was performed. During surgery, a jejunal cystic lesion was incidentally detected and jejunectomy was performed. Microscopically, the cyst was observed to be covered by Keratin 7/Keratin 20 positive intestinal type epithelium and the muscularis layer was shared by the cyst and adjacent jejunum, without a cleavage plane between the cyst wall and jejunal muscularis propria. In the deep muscularis propria, a Heinrich’s type I ectopic pancreas was also noted. In the pancreatic tail, a low grade intraepithelial lesion (panIN-1a) was diagnosed. This case highlights the necessity for a correct differential diagnosis of such rare lesions. Roughly 30 cases of jejunal duplication cysts have been reported to date in the PubMed database.

Keywords: Intestine, Duplication, Embryogenesis, Ectopic pancreas

Core tip: In this paper we presented a very rare case of an incidentally diagnosed jejunal duplication cyst in a patient with a pancreatic tail neoplasm. The association between duplication cyst and ectopic pancreas supports the theory of an embryonal development disorder.