Pancreatic intraepithelial neoplasia arising from an ectopic pancreas in the small bowel

摘要

BACKGROUND: Ectopic pancreatic tissue is relatively uncommon, and is characterized as pancreatic tissue with no contact with the normal pancreas, and with its own ductal system and blood supply. It is usually asymptomatic, and can be incidentally diagnosed by conventional imaging studies. METHOD: A  69-year-old  woman  with  a  prior  history  of bilateral breast carcinoma presented with ectopic pancreatic intraepithelial neoplasia (PanIN) that was identiifed incidentally in  the  small  bowel  during  an  oncological  resection  of  a synchronous primary pancreatic adenocarcinoma, and renal cell carcinoma. RESULTS: The patient underwent subtotal pancreatectomy with splenectomy, regional lymphadenectomy, radical left nephrectomy, and small bowel resection with primary anastomosis of ectopic PanIN-2.  She  had  an  uneventful  hospitalization  and  was discharged home on postoperative day 7. CONCLUSIONS: The occurrence of ectopic PanIN is extremely unusual with only few cases previously reported in the literature. The need for negative margins after surgical resection of ectopic PanIN lesions remains controversial.