Pancreatic adenocarcinoma arising from heterotopic pancreas masquerading as gastritis cystica profunda

Heterotopic pancreas is a rare, benign condition characterized by the presence of pancreatic tissue outside its normal anatomical location, and its association with malignancy is extremely rare. Gastritis cystica profunda (GCP), also a rare condition, is the cystic formation of gastric glands in the...

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Main Authors: Musili Kafaru, BS, Bharti Sharma, MS, M. Maisy Meyer, BS, BA, Shaojun Liu, MD, PhD, Robert Blue, MD, George Agriantonis, MD, FACS, Jennifer Whittington, MD, PhD, FACS, FSSO, Zahra Shafaee, MD, MBA, FACS, FSSO
Format: Article
Language:English
Published: Elsevier 2025-10-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325006028
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author Musili Kafaru, BS
Bharti Sharma, MS
M. Maisy Meyer, BS, BA
Shaojun Liu, MD, PhD
Robert Blue, MD
George Agriantonis, MD, FACS
Jennifer Whittington, MD, PhD, FACS, FSSO
Zahra Shafaee, MD, MBA, FACS, FSSO
author_facet Musili Kafaru, BS
Bharti Sharma, MS
M. Maisy Meyer, BS, BA
Shaojun Liu, MD, PhD
Robert Blue, MD
George Agriantonis, MD, FACS
Jennifer Whittington, MD, PhD, FACS, FSSO
Zahra Shafaee, MD, MBA, FACS, FSSO
author_sort Musili Kafaru, BS
collection DOAJ
description Heterotopic pancreas is a rare, benign condition characterized by the presence of pancreatic tissue outside its normal anatomical location, and its association with malignancy is extremely rare. Gastritis cystica profunda (GCP), also a rare condition, is the cystic formation of gastric glands in the stomach submucosa and/or muscularis propria. We present the case of a 65-year-old male with who presented to the emergency department (ED) with 6 day history of worsening epigastric pain and nonbloody emesis. Computed tomography (CT) revealed gastric outlet obstruction (GOO) caused multiloculated cystic mass in the gastric antrum. Endoscopic evaluation, including esophagogastroduodenoscopy with endoscopic ultrasonography and fine needle aspiration (EGD/EUS-FNA), identified multiple cystic masses in the pylorus and duodenal bulb, which were thought to be GCP. Cytology from the EUS-FNA was benign. Carcinoembryonic antigen (CEA) of aspirated fluid was elevated to 709. The patient underwent endoscopic-guided stent placement to relieve gastric outlet obstruction and subsequent robotic partial gastrectomy. Pathological examination revealed well-differentiated invasive adenocarcinoma arising from ectopic pancreatic tissue. Postoperative imaging of the pancreas revealed no abnormalities. This case underscores the diagnostic challenges in identifying adenocarcinoma arising from heterotopic pancreas, initially misdiagnosed as GCP, and highlights the importance of considering rare causes of gastric masses in clinical practice.
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spelling doaj-art-830fa1d2dddc4f1ba7639ec5eacbc6762025-08-20T03:35:33ZengElsevierRadiology Case Reports1930-04332025-10-0120105090509410.1016/j.radcr.2025.06.057Pancreatic adenocarcinoma arising from heterotopic pancreas masquerading as gastritis cystica profundaMusili Kafaru, BS0Bharti Sharma, MS1M. Maisy Meyer, BS, BA2Shaojun Liu, MD, PhD3Robert Blue, MD4George Agriantonis, MD, FACS5Jennifer Whittington, MD, PhD, FACS, FSSO6Zahra Shafaee, MD, MBA, FACS, FSSO7Department of Surgery, NYC Health + Hospitals/Elmhurst, Queens, NY, USADepartment of Surgery, NYC Health + Hospitals/Elmhurst, Queens, NY, USA; Department of Surgery, Icahn School of Medicine at The Mount Sinai Hospital, New York, NY, USA; Corresponding author.Department of Surgery, Icahn School of Medicine at The Mount Sinai Hospital, New York, NY, USADepartment of Surgery, NYC Health + Hospitals/Elmhurst, Queens, NY, USADepartment of Surgery, NYC Health + Hospitals/Elmhurst, Queens, NY, USADepartment of Surgery, NYC Health + Hospitals/Elmhurst, Queens, NY, USA; Department of Surgery, Icahn School of Medicine at The Mount Sinai Hospital, New York, NY, USADepartment of Surgery, NYC Health + Hospitals/Elmhurst, Queens, NY, USA; Department of Surgery, Icahn School of Medicine at The Mount Sinai Hospital, New York, NY, USADepartment of Surgery, NYC Health + Hospitals/Elmhurst, Queens, NY, USA; Department of Surgery, Icahn School of Medicine at The Mount Sinai Hospital, New York, NY, USAHeterotopic pancreas is a rare, benign condition characterized by the presence of pancreatic tissue outside its normal anatomical location, and its association with malignancy is extremely rare. Gastritis cystica profunda (GCP), also a rare condition, is the cystic formation of gastric glands in the stomach submucosa and/or muscularis propria. We present the case of a 65-year-old male with who presented to the emergency department (ED) with 6 day history of worsening epigastric pain and nonbloody emesis. Computed tomography (CT) revealed gastric outlet obstruction (GOO) caused multiloculated cystic mass in the gastric antrum. Endoscopic evaluation, including esophagogastroduodenoscopy with endoscopic ultrasonography and fine needle aspiration (EGD/EUS-FNA), identified multiple cystic masses in the pylorus and duodenal bulb, which were thought to be GCP. Cytology from the EUS-FNA was benign. Carcinoembryonic antigen (CEA) of aspirated fluid was elevated to 709. The patient underwent endoscopic-guided stent placement to relieve gastric outlet obstruction and subsequent robotic partial gastrectomy. Pathological examination revealed well-differentiated invasive adenocarcinoma arising from ectopic pancreatic tissue. Postoperative imaging of the pancreas revealed no abnormalities. This case underscores the diagnostic challenges in identifying adenocarcinoma arising from heterotopic pancreas, initially misdiagnosed as GCP, and highlights the importance of considering rare causes of gastric masses in clinical practice.http://www.sciencedirect.com/science/article/pii/S1930043325006028PancreaticGastric massesGastritis cystica profundaHeterotopic pancreasRobotic partial gastrectomy
spellingShingle Musili Kafaru, BS
Bharti Sharma, MS
M. Maisy Meyer, BS, BA
Shaojun Liu, MD, PhD
Robert Blue, MD
George Agriantonis, MD, FACS
Jennifer Whittington, MD, PhD, FACS, FSSO
Zahra Shafaee, MD, MBA, FACS, FSSO
Pancreatic adenocarcinoma arising from heterotopic pancreas masquerading as gastritis cystica profunda
Radiology Case Reports
Pancreatic
Gastric masses
Gastritis cystica profunda
Heterotopic pancreas
Robotic partial gastrectomy
title Pancreatic adenocarcinoma arising from heterotopic pancreas masquerading as gastritis cystica profunda
title_full Pancreatic adenocarcinoma arising from heterotopic pancreas masquerading as gastritis cystica profunda
title_fullStr Pancreatic adenocarcinoma arising from heterotopic pancreas masquerading as gastritis cystica profunda
title_full_unstemmed Pancreatic adenocarcinoma arising from heterotopic pancreas masquerading as gastritis cystica profunda
title_short Pancreatic adenocarcinoma arising from heterotopic pancreas masquerading as gastritis cystica profunda
title_sort pancreatic adenocarcinoma arising from heterotopic pancreas masquerading as gastritis cystica profunda
topic Pancreatic
Gastric masses
Gastritis cystica profunda
Heterotopic pancreas
Robotic partial gastrectomy
url http://www.sciencedirect.com/science/article/pii/S1930043325006028
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