Zhang Peng, Wang Mojin, Bai Lifen, Zhuang Wen
Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Sichuan, China.
J Surg Case Rep. 2019 Jul 11;2019(7):rjz217. doi: 10.1093/jscr/rjz217. eCollection 2019 Jul.
Ectopic pancreas is defined as pancreatic tissues having no anatomic or vascular connections with the orthotopic pancreas. It is difficult for clinicians to diagnose this disease without performing a histopathological examination because it lacks specific clinical manifestations. This case report is of a 46-year-old woman who presented with epigastric pain. She had elevated serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 72-4 (CA72-4). Abdominal contrast-enhanced computed tomography (CT) revealed a persistently enhanced mass in the proximal jejunum, which was confirmed as ectopic pancreas via histopathological examination. Her serum CEA and CA72-4 levels were restored to normal ranges after resecting the jejunal ectopic pancreas. This is the first reported case of ectopic pancreas causing an elevation in serum CEA and CA-724 levels; this report supports the metaplasia theory and suggests that jejunal masses should be cautiously diagnosed for avoiding unnecessary concerns among patients and their families.
异位胰腺被定义为与正常位置胰腺无解剖或血管连接的胰腺组织。由于缺乏特异性临床表现，临床医生在不进行组织病理学检查的情况下很难诊断这种疾病。本病例报告的是一名46岁出现上腹部疼痛的女性。她的癌胚抗原（CEA）和糖类抗原72-4（CA72-4）血清水平升高。腹部增强计算机断层扫描（CT）显示空肠近端有一个持续强化的肿块，经组织病理学检查确认为异位胰腺。切除空肠异位胰腺后，她的血清CEA和CA72-4水平恢复到正常范围。这是首例报道的异位胰腺导致血清CEA和CA-724水平升高的病例；本报告支持化生理论，并建议对空肠肿块进行谨慎诊断，以避免患者及其家属产生不必要的担忧。
