Heterotopic ileal pancreas with lipoma and coexisting fibromatosis associated with a rare case of gastrointestinal bleeding. A case report and review of the literature.
BACKGROUND
The development of pancreatic tissue outside the confines of the main gland represents a congenital abnormality referred to as heterotopic pancreas. This is a rare pathological and surgical entity which remains mostly asymptomatic.


METHODS
We present the case of a 28-year-old male, who was admitted to hospital because of a history of blood in bowel movements. After a normal gastroscopy and colonoscopy, Tc99m-tagged red blood cells scintigraphy showed enrichment in the right lower abdomen. At double-balloon endoscopy, a intraluminal polypoid mass 8 cm in diameter was revealed 120 cm from the ileocecal valve. The initial macroscopic diagnosis was a gastrointestinal stromal tumor. During surgery, the diagnosis of heterotopic pancreas with lipoma and fibromatosis was made. To our knowledge this is the first case of ileal heterotopic pancreatic tissue and lipoma described to date in the literature.


CONCLUSIONS
Ileal heterotopic pancreas is a rare entity with potentially life-threatening complications, local excision being the appropriate indicated treatment.
Fikatas
Panagiotis
P
Department of General, Visceral and Transplantation Surgery, Charité Virchow Clinic, Berlin, Germany. panagiotis.fikatas@charite.de
Sauer
Igor Maximilian
IM
Mogl
Martina
M
Menenakos
Charalambos
C
Luegering
Andreas
A
Schumacher
Guido
G
Langrehr
Jan
J
Neuhaus
Peter
P