Chatziantoniou Georgios, Tzikos Georgios, Ioannidis Aristeidis, Loukousia Antonia, Raptou Georgia, Michalopoulos Antonios, Paramythiotis Daniel
1st Propaedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54621, Thessaloniki, Greece.
Pathology Department, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Ann Med Surg (Lond). 2022 Apr 29;77:103698. doi: 10.1016/j.amsu.2022.103698. eCollection 2022 May.
and importance: Ectopic pancreatic tissue (EPT) is a rare clinical entity, which is defined as the presence of pancreatic tissue without any anatomic or vascular connection with the main body of the pancreas. EPT could be found anywhere in the gastrointestinal tract; most commonly in stomach. The aim of this study is to present a rare case report of EPT located in the gallbladder.
A 37-year-old woman was scheduled in our surgical department for elective laparoscopic cholecystectomy due to symptomatic chololithiasis. Preoperative ultrasound imaging was indicative only for the presence of multiple stone tin the gallbladder's fundus. The patient had an uneventful recovery and discharged the first postoperative day. Surprisingly, the final pathology report of the specimen referred the existence of EPT in the subserosa territory, as an incidental finding.
EPT is almost impossible to be diagnosed preoperatively due to its various clinical presentation and the low discriminating power of all the usual imaging tests. However, given the potential malignant transformation of the EPT, physicians should be aware of this clinical entity and consider cholecystectomy immediately when it is highly suspected.
EPT in the gallbladder is a very rare finding. There are no established "gold standard" techniques to identify it preoperatively. The patients are either asymptomatic or presenting with non-specific symptoms and almost always the pathology examination, after cholecystectomy, establishes the definite diagnosis.
异位胰腺组织(EPT)是一种罕见的临床实体,定义为存在与胰腺主体无任何解剖或血管连接的胰腺组织。EPT可在胃肠道的任何部位发现;最常见于胃。本研究的目的是报告一例位于胆囊的EPT罕见病例。
一名37岁女性因有症状的胆石症被安排在我们外科进行择期腹腔镜胆囊切除术。术前超声成像仅显示胆囊底部有多个结石。患者恢复顺利,术后第一天出院。令人惊讶的是,标本的最终病理报告显示在浆膜下区域存在EPT,为偶然发现。
由于EPT临床表现多样且所有常规影像学检查的鉴别能力较低,术前几乎不可能诊断。然而,鉴于EPT有潜在恶变可能,医生应了解这一临床实体,高度怀疑时应立即考虑行胆囊切除术。
胆囊内的EPT是非常罕见的发现。目前尚无术前识别它的既定“金标准”技术。患者要么无症状,要么表现为非特异性症状,几乎总是在胆囊切除术后经病理检查才能确诊。