Intraductal Papillary Mucinous Neoplasm Arising in a Heterotopic Pancreas Treated by Percutaneous Endoscopic Intragastric Surgery

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  • Moue Shoko
    Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, University of Tsukuba
  • Akashi Yoshimasa
    Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, University of Tsukuba
  • Ogawa Koichi
    Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, University of Tsukuba
  • Hisakura Katsuji
    Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, University of Tsukuba
  • Enomoto Tsuyoshi
    Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, University of Tsukuba
  • Ohara Yusuke
    Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, University of Tsukuba
  • Owada Yohei
    Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, University of Tsukuba
  • Sakashita Shingo
    Department of Diagnostic Pathology, University of Tsukuba
  • Oda Tatsuya
    Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, University of Tsukuba

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Other Title
  • 幽門輪に近接した胃異所性膵管内乳頭粘液性腫瘍に対して胃内手術により幽門機能温存が得られた1例

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<p>We report a case of intraductal papillary mucinous neoplasm (IPMN) arising in the heterotopic pancreas of the stomach which was successfully removed by percutaneous endoscopic intragastric surgery (PEIGS). A 42-year-old man was given a diagnosis of gastric submucosal tumor (SMT) during a medical check-up. Abdominal CT scan and MRI imaging revealed a multicystic lesion in the tumor mass which was diagnosed as heterotopic pancreas with cystic component (IPMN or pseudocyst). The tumor was located in the antrum of the stomach and adjacent to the pyloric ring; therefore, we selected PEIGS as a surgical procedure to preserve gastric function for clinically benign tumor treatment. Pathological examination revealed multiple dilated pancreatic ducts with pyloric gland-like structures in the heterotopic pancreatic tissues. Based on pathological findings, the tumor was finally diagnosed as heterotopic pancreas with gastric type IPMN. We considered PEIGS as a suitable procedure for the intraluminal SMT adjacent to the pyloric ring for its functional preservation.</p>

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