Abstract
A 62-year-old woman who visited a neighboring hospital because of nausea was suspected to have organic passage disturbance of the stomach by a gastric endoscopy and was referred to our hospital. Gastric endoscopy revealed a ridging lesion suggestive of a submucosal tumor from the pyloric antrum to the pyloric ring, but no malignant findings were gained despite four biopsies of the lesion. A contrast-enhanced abdominal CT scan showed a localized thickening with faint enhancement effect at the pyloric antrum, a submucosal tumor being likely. In order to improve the symptoms due to the stenosis as well as to make the definite diagnosis, laparotomy was performed with a suspected diagnosis of poorly differentiated adenocarcinoma infiltrating into the submucosal structure of the stomach. It revealed exposure of a tumor on the serous membrane in the pyloric antrum, so that distal gastrectomy with D2 lymph node dissection was performed. The histopathological diagnosis was adenocarcinoma arisen in an ectopic pancreas of the stomach.
Malignant transformation from an ectopic pancreas of the stomach has rarely been reported. Preoperative diagnosis was difficult in our case. In the treatment of pyloric stenosis due to a submucosal tumor like lesion, of which preoperative diagnosis is difficult, malignant neoplasm arisen from an ectopic pancreas of the stomach must be kept in mind as a possible diagnosis.
