Ectopic pancreatic adenocarcinoma in Meckel’s diverticulum: a case report

Abstract Background Malignant neoplasms arising from Meckel’s diverticulum are rare and an adenocarcinoma in Meckel’s diverticulum originating from ectopic pancreatic tissue is even rarer. Herein, we report a patient with an ectopic pancreatic adenocarcinoma in Meckel’s diverticulum who was successf...

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Main Authors: Shoichi Inokuchi, Kohjiro Shirabe, Satoshi Tsutsumi, Hiroomi Takayama, Takahiro Terashi, Kazuhiro Yasuda, Masahiko Ikebe, Toshio Bandoh, Junpei Wada, Shogo Urabe, Tohru Utsunomiya
Format: Article
Language:English
Published: Japan Surgical Society 2024-02-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-024-01843-8
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Summary:Abstract Background Malignant neoplasms arising from Meckel’s diverticulum are rare and an adenocarcinoma in Meckel’s diverticulum originating from ectopic pancreatic tissue is even rarer. Herein, we report a patient with an ectopic pancreatic adenocarcinoma in Meckel’s diverticulum who was successfully treated with surgery and chemotherapy. Case presentation A woman in her sixties presented to another hospital with abdominal pain. Plain computed tomography suggested an abdominal tumor and she was referred to our hospital. Enhanced computed tomography revealed a 23-mm low-density tumor in the abdominal cavity. Surgery was performed with a tentative diagnosis of a mesenteric tumor, such as a gastrointestinal stromal tumor, schwannoma, or lymphoma. First, we inspected the peritoneal cavity with a laparoscope. This revealed numerous nodules in the small bowel mesentery, suggesting peritoneal dissemination. A 20-mm-diameter white tumor was found in the small intestine and diagnosed as a small intestinal cancer. The small intestine was partially resected laparoscopically through a small skin incision. The patient’s postoperative course was uneventful, and she was discharged on postoperative day 9. Pathological examination revealed well-differentiated adenocarcinoma in the small intestine. The tumor had developed from a sac-like portion protruding toward the serosal side and had a glandular structure lined with flattened atypical cells. Neither pancreatic acinar cells nor islets of Langerhans were evident, suggesting a Heinrich type 3 ectopic pancreas. The final diagnosis was an adenocarcinoma originating from an ectopic pancreas in Meckel’s diverticulum. After a smooth recovery, the patient commenced chemotherapy for pancreatic cancer. Conclusions We present a very rare case of ectopic pancreatic carcinoma in Meckel’s diverticulum.
ISSN:2198-7793