Case Report

Salivary Gland Heterotopia in the Gastroesophageal Junction: A Case Series and Review of the Literature

Table 2

Location, clinical features, endoscopic/sigmoidoscopic findings, histopathology, and treatment of 6 cases of gastrointestinal salivary gland choristomas reported in the literature.

SourceAge/ SexLocationClinicalEndoscopy/ SigmoidoscopyHistopathology/ IHCTreatment

Shindo et
al, 1972 [6].
24 mHemorrhoidSevere bleeding by rectum of sudden onset, protrusion, and anal pain, large external and internal hemorrhoids and considerable spasm of the sphincter.N/AEctopic gastric mucosa is of the acid-secreting type normally found lining the corpus and fundus of the stomach. This type of mucosa covers dilated hemorrhoidal veins in this specimen. In another area, proximal to the gastric mucosa, there is a microfocus of mixed serous and mucous glands such as are found normally in the submaxillary salivary glands or in the mucosal glands of the tracheobronchial tree.Resection

Weitzner et
al, 1983 [7].
61 mHemorrhoid1x1 cm anal verge polypN/ALobules of serous and mucous glands and ducts typical of submaxillary glands with and adjacent hyperplastic polypSimoidoscopic removal

Downs-Kelly
et al, 2003 [8].
31 mRectal diverticulumIntermittent rectal bleeding, small mass on the rectal wall. An ultrasound of the rectum revealed a 2 cm mass.Sigmoidoscopy revealed a single diverticulum and an extramucosal mass in the lower rectal segmentIn the submucosal region, multiple foci of serous and mucinous glands and ducts resembling salivary gland tissue were present. Some of these foci were associated with a chronic inflammatory cell infiltrate consisting primarily of lymphocytes.The patient underwent local rectal excision of the 2x 2x 0.8 cm polypoid mass.

Maffini et
al, 2012 [9].
55fLarge bowelColorectal carcinoma screeningA pedunculated polypoid lesion of 1 cm situated at 19 cm from the anal verge, resembling a submucosal lipoma without other mucosal alterationsA small aggregate of acinar glands with mixed mucous–serous features in the submucosa and an intercalated duct composed of a double layer of cells – epithelial and myoepithelial – that reached the mucosal surface. The glands were positive for lysozyme antibody and negative for pancreatic amylase, S-100 protein, chromogranin, and synaptophysinEndoscopic resection

Olajide,
2013 [10].
5fJejunumSevere, intermittent abdominal pain with occasional postprandial vomitingA pale yellow subserosal lesion was seen in the antimesenteric border of the jejunum about 45 cm from the duodeno-jejunal junction.Submucosal tissue with lobules of serous glands with central lumen, reminiscent of salivary glands. The glands are composed of benign epithelial cells with regular nuclei and ample eosinophilic cytoplasm.Wedge resection

Wang et
al, 2014 [11].
60 mEsophagusBelch, regurgitation, and abdominal pain1.2 × 1.0 cm mucosal protuberant lesion situated 38 cm from the incisorsSalivary gland tumor, partly basal cell adenoma, partly with the structure of adenoid cystic carcinoma, the glands were positive for CD117, P63, PDGFR, P53, Ki-67, CEA, P-CK, Vimentin, PAS, S-100, Calponin, and CK5/6.Endoscopic resection