A Case of Adenocarcinoma arising from Ectopic Gastric Pancreas with Carcinomatous Peritonitis

Jun Kimura, Masahide Kaji, Sei-ichi Yamamoto, Ki-ichi Maeda, Kazuhisa Yabushita, Kohji Konishi, Hitoshi Abo*, Akio Uchiyama** and Atsuo Miwa**

Department of Surgery, Department of Radiology* and Department of Pathology**, Toyama Prefectural Central Hospital

A 31-year-old woman with epigastralgia was found in gastrointestinal series and gastrointestinal fiberscopy studies to have severe stenosis of the pyloric ring, although histopathological examination showed no malignancy. Blood tumor markers were elevated- (CA19-9: 660 U/ml; CA125: 40.8 U/ml). CEA 0.5 ng/ml was normal. Abdominal computed tomography showed wall thickening of the pyloric ring and moderate ascites, necessitating diagnostic surgery. Surgery showed 5.0×2.0 cm submucosal tumor of the pyloric ring and carcinomatous peritonitis. To treat stenosis, we conducted distal partial gastrectomy. Postoperative histopathological findings showed adenocarcinoma arising from an ectopic gastric pancreas (Heinlich type II). Postoperative abdominal magnetic resonance imaging (MRI) showed the pancreatic duct of ectopic gastric pancreas in the pyloric ring. This case suggested MRI is effective for diagnosis of ectopic pancreas.

Key words
aberrant pancreas, carcinomatous peritonitis, MRI

Reprint requests
Jun Kimura Department of Surgery, National Hospital Organaization Yokohama Medical
3-60-2 Harajyuku, Totsukaku, 245-8575 JAPAN

Accepted
October 29, 2007

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