Heterotopic/ectopic pancreas

Functioning pancreatic tissue in an abnormal anatomic location

Epidemiology

• Found in 0.5-14% of autopsy specimens
• Can arise anywhere in foregut
• Most common location is within the stomach, typically along the antral greater curvature
• Also within duodenum and Meckel's

Presentation

• Typically vague abdominal pain
• Can cause bowel obstruction by intussusception, bleeding and ulceration
• Reports of pancreatitis, islet cell tumours, and pancreatic adenocarcinoma within these lesions - however very rare
• Can be seen incidentally as firm yellow submucosal nodules

Workup

• Endoscopy
  • Small submucosal masses - may be confused with a GIST
• CT
  • Small submucosal masses

Management

• Surgical excision if symptomatic
• Otherwise can be left alone