title: Pancreatic intraepithelial neoplasia arising from an ectopic pancreas in the small bowel.
abstract: 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.
  
  
  METHODS
  A 69-year-old woman with a prior history of bilateral breast carcinoma presented with ectopic pancreatic intraepithelial neoplasia (PanIN) that was identified 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.
authors.affiliation: Department of General Surgery, Providence Hospital and Medical Centers, Southfield, MI 48075, USA. igormacedo1@hotmail.com.
authors.forename: Francisco Igor
authors.initials: FI
authors.lastname: Macedo
authors.forename: Deepa
authors.initials: D
authors.lastname: Taggarshe
authors.forename: Tafadzwa
authors.initials: T
authors.lastname: Makarawo
authors.forename: Barry
authors.initials: B
authors.lastname: Herschman
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Jacobs
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery; D002278:Carcinoma in Situ / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000601:surgery; D002292:Carcinoma, Renal Cell / Q000601:surgery; D002828:Choristoma / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D033162:Incidental Findings; D007579:Jejunal Diseases / Q000175:diagnosis / Q000601:surgery*; D007680:Kidney Neoplasms / Q000601:surgery*; D009378:Neoplasms, Multiple Primary / Q000601:surgery*; D016609:Neoplasms, Second Primary / Q000601:surgery*; D010179:Pancreas; D010190:Pancreatic Neoplasms / Q000601:surgery*