Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Adenocarcinoma arising in a heterotopic pancreas (Heinrich type III): a case report | Inoue et al. Journal of Medical Case Reports 2010 4 39 http content 4 1 39 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Adenocarcinoma arising in a heterotopic pancreas Heinrich type III a case report Yoshihiro Inoue1 Michihiro Hayashi1 Yoshifumi Arisaka2 Kazuhide Higuchi2 Yutaro Egashira3 Nobuhiko Tanigawa1 Abstract Introduction Heterotopic pancreatic cancer in the duodenum is a very rare disease. Only twelve cases have been reported worldwide to date. We report a rare case of malignant transformation of heterotopic pancreas Heinrich type III in the duodenum with long-term survival of the patient and review the 12 cases in the literature. Case presentation A 75-year-old Japanese man was admitted to our hospital complaining of nausea and vomiting. Endoscopy and upper gastrointestinal contrast study showed marked duodenal stenosis. A pyloruspreserving pancreaticoduodenectomy was performed. Histopathological examination of the surgically resected specimen showed malignant transformation of heterotopic pancreas Heinrich type III in the duodenum. The postoperative course was uneventful and the patient was discharged from the hospital on postoperative day 30. He is well and shows no signs of recurrence at the time of writing six years after the surgery. Conclusion Adenocarcinoma arising within the heterotopic pancreas appears to be rare. It is difficult to obtain a correct diagnosis preoperatively. The management of heterotopic pancreas depends on the presence or absence of symptoms. If the patient is asymptomatic or benign conservative treatment with regular follow-up is recommended. When the patient is symptomatic or there is a suspicion of malignancy surgical management with intra-operative frozen section diagnosis is indicated. Introduction Shultz was first to describe heterotopic pancreas in 1727 although histological data was not available until the report by Klob in 1859. Heterotopic pancreas is also called aberrant .
