Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2021; 9(27): 8147-8156
Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8147
Asymptomatic gastric adenomyoma and heterotopic pancreas in a patient with pancreatic cancer: A case report and review of the literature
Kun Li, Yan Xu, Nan-Bin Liu, Bao-Min Shi
Kun Li, Yan Xu, Nan-Bin Liu, Bao-Min Shi, Department of General Surgery, Tongji Hospital of Tongji University, Shanghai 200065, China
Author contributions: Shi BM contributed to the conception and design of the study and performed the operation on the patient; Li K collected the data, performed the data analysis, and wrote the initial draft of the manuscript; Yan X and Liu NB participated in the clinical management and follow-up of the patient and analyzed and interpretated the data; all authors contributed to drafting and revising the manuscript and approved the submitted version.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest related to this manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Bao-Min Shi, MD, Professor, Department of General Surgery, Tongji Hospital of Tongji University, No. 389 Xincun Road, Putuo District, Shanghai 200065, China. tjshibaomin@tongji.edu.cn
Received: April 8, 2021
Peer-review started: April 8, 2021
First decision: May 11, 2021
Revised: May 24, 2021
Accepted: July 23, 2021
Article in press: July 23, 2021
Published online: September 26, 2021
Processing time: 160 Days and 19 Hours
Abstract
BACKGROUND

Gastric adenomyoma (GA) is a rare submucosal benign neoplasm that occurs mostly in the gastric antrum and is often misdiagnosed. No standard treatment has been established for this disease in cases of malignancy.

CASE SUMMARY

A 75-year-old woman with a 10-year history of hypertension was admitted to the Emergency Department of our hospital complaining of paroxysmal exacerbation of acute abdominal pain for 1 d with no apparent cause. Enhanced computed tomography and magnetic resonance imaging indicated a mass in the caudal pancreas, cholecystitis, and cholecystic polypus. Gastrointestinal endoscopy showed a mass arising from the gastric antrum. Due to the imaging findings, pancreatic cancer (PC), gastric lesion, cholecystitis, and cholecystic polypus were our primary consideration. Radical pancreatectomy, splenectomy, and cholecystectomy were performed successfully, and the gastric tumor was locally resected. Postoperative paraffin specimens confirmed the diagnosis of caudal PC, GA, and heterotopic pancreas (HP). Unfortunately, the patient died 13 mo later due to PC metastases to the liver, lung, and adrenal glands.

CONCLUSION

GA is a rare benign disease, especially when occurring with HP. It may stem from the same origin as HP. This is the first case report to date of a patient suffering from the simultaneous occurrence of GA, HP, and PC. GA is a lesion that can mimic other benign or malignant gastrointestinal diseases; thus, a definitive diagnosis depends on postoperative pathological biopsy. Although GA and HP are both benign lesions, they should be resected because there is a chance of malignancy. Additional research should be conducted to better understand these submucosal lesions.

Keywords: Gastric adenomyoma; Heterotopic pancreas; Case report; Literature review; Radiological performance; Pathological performance

Core Tip: Gastric adenomyoma (GA) is a rare gastric submucosal disease that is even rarer when combined with heterotopic pancreas (HP) or pancreatic cancer (PC). HP and GA may have the same origin. This is the first case report of the simultaneous occurrence of GA, HP, and PC. In addition, 24 patients with HP and GA were investigated to identify variations among the cases and clarify the importance of surgical resection. GA can mimic other benign or malignant gastrointestinal diseases; thus, a definitive diagnosis depends on postoperative paraffin biopsy. Surgery is a vital procedure to cure GA and HP in cases of malignant transformation.