Department of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Hum Pathol. 2010 Dec;41(12):1809-13. doi: 10.1016/j.humpath.2010.06.005. Epub 2010 Sep 24.
Pancreatic heterotopia has been described at several abdominal and intrathoracic locations, most commonly in the stomach and upper part of the small intestine. Its occurrence in the rectum is unusual, and malignant transformation in the rectum has not been reported. We report a case of ductal adenocarcinoma arising in a rectal pancreatic heterotopia in a 42-year-old woman with delayed local recurrence. The tumor was composed of well to moderately differentiated ductal adenocarcinoma infiltrating through the full thickness of the anorectal wall with extension into the vaginal septum. A focus of ectopic pancreas consisting of exocrine acini and small ducts adjacent to the tumor with some ducts showing mild to severe dysplasia reminiscent of pancreatic intraepithelial neoplasia was also observed. Although our literature search found 31 documented reports of tumors arising in the heterotopic pancreas, the present case is the first case of ductal adenocarcinoma arising in a focus of pancreatic heterotopia in the rectum.
胰腺异位已在多个腹部和胸腔位置被描述，最常见于胃和小肠上段。其在直肠的发生较为罕见，且直肠的恶性转化尚未被报道。我们报告了一例 42 岁女性直肠胰腺异位中发生的导管腺癌，其存在局部复发延迟。肿瘤由分化良好至中等的导管腺癌组成，穿透整个肛管直肠壁，并延伸至阴道隔。还观察到紧邻肿瘤的异位胰腺的一个焦点，其由外分泌腺泡和小导管组成，一些导管显示出轻度至重度异型增生，类似于胰腺上皮内瘤变。尽管我们的文献检索发现了 31 份关于异位胰腺中发生肿瘤的有记录报告，但本病例是首例发生于直肠异位胰腺焦点的导管腺癌。
