Ectopic pancreas tissue in the posterior mediastinum.

Computed tomography Ectopic pancreas Magnetic resonance imaging Mediastinitis Posterior mediastinum

Journal

Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113

Informations de publication

Date de publication:
06 Apr 2024
Historique:
received: 17 04 2023
accepted: 27 03 2024
medline: 7 4 2024
pubmed: 7 4 2024
entrez: 6 4 2024
Statut: epublish

Résumé

The occurrence of ectopic pancreas in the mediastinum is rare. Herein, we report a 22-year-old female who presented with right shoulder pain, dysphagia, fever and headaches. Chest computer tomography revealed a mass in the posterior mediastinum with accompanying signs of acute mediastinitis. Needle biopsy and fine-needle aspiration revealed ectopic gastral tissue and ectopic pancreas tissue, respectively. Surgical resection was attempted due to recurring acute pancreatitis episodes. However, due to chronic-inflammatory adhesions of the mass to the tracheal wall, en-bloc resection was not possible without major tracheal resection. Since then, recurring pancreatitis episodes have been treated conservatively with antibiotics. We report this case due to its differing clinical and radiological findings in comparison to previous case reports, none of which pertained a case of ectopic pancreas tissue in the posterior mediastinum with recurring acute pancreatitis and mediastinitis.

Identifiants

pubmed: 38582893
doi: 10.1186/s13019-024-02698-8
pii: 10.1186/s13019-024-02698-8
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

184

Informations de copyright

© 2024. The Author(s).

Références

Carr MJ, Deiraniya AK, Judd PA. Mediastinal cyst containing mural pancreatic tissue. Thorax. 1977;32(4):512–6. https://doi.org/10.1136/thx.32.4.512 . PMID: 337563; PMCID: PMC470664.
doi: 10.1136/thx.32.4.512 pubmed: 337563 pmcid: 470664
Shillitoe AJ, Wilson JE. Enterogenous cyst of thorax with pancreatic tissue as a constituent. J Thorac Surg. 1957;34(6):810–4. PMID: 13482025.
doi: 10.1016/S0096-5588(20)30300-7 pubmed: 13482025
Perez-Ordonez B, Wesson DE, Smith CR, Asa SL. A pancreatic cyst of the anterior mediastinum. Mod Pathol. 1996;9(3):210-4. PMID: 8685216.
Cagirici U, Ozbaran M, Veral A, Posacioglu H. Ectopic mediastinal pancreas. Eur J Cardiothorac Surg. 2001;19(4):514-5. https://doi.org/10.1016/s1010-7940(01)00606-6 . PMID: 11306324.
Iglesias Sentís M, Belda Sanchís J, Gimferrer Garolera JM, Catalán Biela M, Rubio Garay M, Ramírez Ruz J. Quiste entérico mediastínico: presentación clínica e histopatología inusuales [Mediastinal enteric cyst: unusual clinical presentation and histopathology]. Arch Bronconeumol. 2004;40(4):185–7. Spanish. PMID: 15030734.
doi: 10.1016/S0300-2896(04)75500-3 pubmed: 15030734
Tamura Y, Takahama M, Kushibe K, Taniguchi S. Ectopic pancreas in the anterior mediastinum. Jpn J Thorac Cardiovasc Surg. 2005;53(9):498–501. https://doi.org/10.1007/s11748-005-0095-6 . PMID: 16200892.
Al-Salam S, Al Ashari M. Ectopic pancreatic tissue in the anterior mediastinum. Virchows Arch. 2006;448(5):661-3. https://doi.org/10.1007/s00428-006-0159-8 . Epub 2006 Mar 1. PMID: 16508781.
Wang W, Li K, Qin W, Sun H, Zhao C. Ectopic pancreas in mediastinum: report of 2 cases and review of the literature. J Thorac Imaging. 2007;22(3):256-8. https://doi.org/10.1097/01.rti.0000213587.44719.a7 . PMID: 17721336.
Chen ZH, Yu RS, Dong F, Wang XJ. CT findings of an ectopic pancreas in the anterior mediastinum. Korean J Radiol. 2009;10(5):527–30. https://doi.org/10.3348/kjr.2009.10.5.527 . Epub 2009 Aug 25. PMID: 19721841; PMCID: PMC2731874.
Fayoumi S, Al-Husseini L, Jalil R, Abbasi S. Ectopic pancreatic tissue in the thoracic cavity: report of two cases. Ann Thorac Surg. 2010;90:e25–7.
doi: 10.1016/j.athoracsur.2010.05.059 pubmed: 20667307
Szabados S, Lénárd L, Tornóczky T, Várady E, Verzár Z. Ectopic pancreas tissue appearing in a mediastinal cyst. J Cardiothorac Surg. 2012;7:22. https://doi.org/10.1186/1749-8090-7-22 . PMID: 22414327; PMCID: PMC3312824.
doi: 10.1186/1749-8090-7-22 pubmed: 22414327 pmcid: 3312824
Byun CS, Park IK, Kim H, Yu W. Ectopic pancreas with hemorrhagic cystic change in the anterior mediastinum. Korean J Thorac Cardiovasc Surg. 2012;45(2):131–3. https://doi.org/10.5090/kjtcs.2012.45.2.131 . Epub 2012 Apr 3. PMID: 22500286; PMCID: PMC3322185.
doi: 10.5090/kjtcs.2012.45.2.131 pubmed: 22500286 pmcid: 3322185
Rokach A, Izbicki G, Deeb M, Bogot N, Arish N, Hadas-Halperen I, Azulai H, Bohadana A, Golomb E. Ectopic pancreatic pseudocyst and cyst presenting as a cervical and mediastinal mass: case report and review of the literature. Diagn Pathol. 2013;8:176. https://doi.org/10.1186/1746-1596-8-176 . PMID: 24152726; PMCID: PMC3817996.
doi: 10.1186/1746-1596-8-176 pubmed: 24152726 pmcid: 3817996
Li WW, van Boven WJ, Jurhill RR, Bonta PI, Annema JT, de Mol BA. Ectopic pancreas in a giant mediastinal cyst. Clin Respir J. 2016;10(1):125–8. https://doi.org/10.1111/crj.12176 . Epub 2014 Aug 13. PMID: 24988877.
doi: 10.1111/crj.12176 pubmed: 24988877
Zhang L, Peng LQ, Yu JQ, Yuan HM, Chu ZG, Zeng HJ, Wei B. Ectopic pancreas in the anterior mediastinum: a report of two cases and review of the literature. Oncol Lett. 2014;7(4):1053–6. https://doi.org/10.3892/ol.2014.1840 . Epub 2014 Jan 29. PMID: 24660035; PMCID: PMC3961199.
doi: 10.3892/ol.2014.1840 pubmed: 24660035 pmcid: 3961199
Koh HM, Chang JW, Jeong SY, Hyun CL, Kim YS, Jang BG, Maeng YH. Ectopic pancreas presenting as a solid mediastinal mass. Int J Surg Pathol. 2015;23(7):585–8. https://doi.org/10.1177/1066896915596810 . Epub 2015 Jul 27. PMID: 26215218.
doi: 10.1177/1066896915596810 pubmed: 26215218
Njem JM, Ugwu B, Collins J, Emmanuel I, Philip OA, Awodi J. Aberrant pancreatic tissue in a giant mediastinal cyst: an uncommon entity. J Cardiothorac Surg. 2019;14(1):134. https://doi.org/10.1186/s13019-019-0955-2 . PMID: 31286963; PMCID: PMC6615225.
doi: 10.1186/s13019-019-0955-2 pubmed: 31286963 pmcid: 6615225
Bernal C, Accinelli RA, Fuentes-Rivera G, Díaz J, Chá Vez W, Valdivia E, Morello E, Tafur K, Gayoso O. Pá ncreas ectópico torá cico [Ectopic thoracic pancreas]. Rev Gastroenterol Peru. 2020;40(1):69–72. Spanish. PMID: 32369469.
Wu L, Lin L, Jiang L, Jiang G. Ectopic pancreas in mediastinum presenting as hemoptysis. Ann Thorac Surg. 2015;100(6):2368. https://doi.org/10.1016/j.athoracsur.2015.08.064 . PMID: 26652539.
Zhao H, Zhang Z, Li X, Liu J, Zhang H, Chen G, Chen J. Resection of anterior mediastinal ectopic pancreas by right thoracoscopy: a case report. Mol Clin Oncol. 2019;11(2):147–50. https://doi.org/10.3892/mco.2019.1878 . Epub 2019 Jun 13. PMID: 31316773; PMCID: PMC6604395.
doi: 10.3892/mco.2019.1878 pubmed: 31316773 pmcid: 6604395
Rochefort MM, LeSiege CJ, Shi W, Sholl LM. Ectopic anterior mediastinal pancreas: an unusual case of new onset hemoptysis. Ann Thorac Surg. 2022;113(5):e367–9. https://doi.org/10.1016/j.athoracsur.2021.07.012 . Epub 2021 Jul 27. PMID: 34329599.
doi: 10.1016/j.athoracsur.2021.07.012 pubmed: 34329599
Iijima Y, Iwai S, Yamagata A, Motono N, Usuda K, Kumagai M, Takeuchi S, Yamaghishi S, Koizumi K, Uramoto H. Anterior mediastinal ectopic pancreatic cyst incidentally identified by pericarditis: a case report. Gen Thorac Cardiovasc Surg. 2021;69(3):597–600. https://doi.org/10.1007/s11748-020-01537-6 . Epub 2020 Nov 2. PMID: 33136258.
doi: 10.1007/s11748-020-01537-6 pubmed: 33136258
Snak Y, Dwianingsih EK, Sumpono ASB, Panji R, Rahman A, Ghozali A, Amr SS. Mediastinal ectopic pancreas with abundant endocrine cells coexisting with mediastinal cyst and thymic hyperplasia. Case Rep Pathol. 2018;2018:8270516. https://doi.org/10.1155/2018/8270516 . PMID: 29977637; PMCID: PMC5994262.
doi: 10.1155/2018/8270516 pubmed: 29977637 pmcid: 5994262
von Schweinitz D, Wittekind C, Freihorst J. Mediastinaler sequester mit ektopem pankreasgewebe [mediastinal sequestration with ectopic pancreatic tissue]. Z Kinderchir. 1990;45(4):249–50. German. PMID.
Fayoumi S, Al-Husseini L, Jalil R, Abbasi S. Ectopic pancreatic tissue in the thoracic cavity: report of two cases. Ann Thorac Surg. 2010;90(2):e25–7. https://doi.org/10.1016/j.athoracsur.2010.05.059 . PMID: 20667307.
Wu J, Chen Y, Ni X. Ectopic pancreas in anterior mediastinal with pseudocyst: one case report. Chin J Thorac Cardiovasc Surg. 1998;14:214.
Ehricht A, Pützschler F, Weissmann K, Klenske M. Ektopes pankreasgewebe in einer mediastinalzyste - eine seltene klinische manifestation [Ectopic pancreatic tissue within a mediastinal cyst–a rare clinical manifestation]. Zentralbl Chir. 2009;134(2):178–81. German. https://doi.org/10.1055/s-2008-1076882 . Epub 2009 Apr 20. PMID: 19382052.
Takemura M, Yoshida K, Morimura K. Thoracoscopic resection of thoracic esophageal duplication cyst containing ectopic pancreatic tissue in adult. J Cardiothorac Surg. 2011;6:118. https://doi.org/10.1186/1749-8090-6-118 . PMID: 21943206; PMCID: PMC3189109.
doi: 10.1186/1749-8090-6-118 pubmed: 21943206 pmcid: 3189109
St Romain P, Muehlebach G, Damjanov I, Fan F. Adenocarcinoma arising in an ectopic mediastinal pancreas. Ann Diagn Pathol. 2012;16:494–7.
doi: 10.1016/j.anndiagpath.2011.04.005 pubmed: 21724430
Sakurai H, Kanesaka T, Ikezawa K. Mediastinal ectopic pancreas diagnosed by endoscopic ultrasonography-guided fine-needle aspiration. Dig Endosc. 2022;34(1):249. https://doi.org/10.1111/den.14189 . Epub 2021 Nov 24. PMID: 34773295.
doi: 10.1111/den.14189 pubmed: 34773295
Makhlouf HR, Almeida JL, Sobin LH. Carcinoma in jejunal pancreatic heterotopia. Arch Pathol Lab Med. 1999;123(8):707–11. https://doi.org/10.5858/1999-123-0707-CIJPH . PMID: 10420228.

Auteurs

Zeynep Berkarda (Z)

Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Freiburg, Germany. zeynep.berkarda@uniklinik-freiburg.de.

Jasmina Kuvendjiska (J)

Department of General and Visceral Surgery, University Medical Center Freiburg, Freiburg, Germany.

Fabian Bamberg (F)

Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Freiburg, Germany.

Elmar Kotter (E)

Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Freiburg, Germany.

Classifications MeSH