Case Report

A Case of Heterotopic Pancreatic Tissue Discovered in the Distal Esophagus

Table 1

Reported cases of heterotopic pancreas in the esophagus among adults in the medical literature.

CaseAgeSexLocationPresentationTreatmentFollow-up

Crighton and Botha [15]58FGEJProgressive dysphagia due to IPMNLaparoscopic/thorascopic ILEAsymptomatic at 3 months
Temes et al. [10]24F4.5  cm mass 3  cm proximal to the GEJ5 days of nausea, vomiting, fever, chest pain, SOB due to esophageal rupture, and empyemaEsophageal enucleation, esophageal mucosa, and muscle closedAsymptomatic at 1 year
Lowry et al. [1]25MMass located in submucosa of distal esophagusRUQ and epigastric abdominal pain. EGD showed fistulous tracts 3  cm proximal to GEJ and stomach noduleVATS resectionAsymptomatic at 2 months
Noffsinger et al. [5]47FDistal esophagusEpigastric abdominal pain, unable to tolerate solid foods, poor appetite, and weight loss for 2  weeks that was found to have 9 cm mass at the GEJILE, pyloroplasty, Witzel jejunostomyInfections and respiratory distress postoperative
Goto et al. [13]63M∼2  cm in diameter submucosal tumor in the middle third of esophagusAsymptomatic, incidental findingConservative managementAsymptomatic for 5 years
Ulrych et al. [17]34MTumor arising from the lower esophagusSeveral years of dyspepsia with 3  months of progressive dysphagia, odynophagia, and regurgitation. Weight loss and weakness.Left posterolateral thoracotomy, primary anastomosis, and partial fundoplicationAsymptomatic at 3 months
Gananadha and Hunt [12]26FMass located in the wall of the distal esophagus; caudal portion was involved with GEJEpisodes of severe epigastric pain, occurring after food intake, and nauseaDiagnostic laparoscopy discovered mass in the wall of distal esophagus. Cephalad portion was cystic which was separated from esophageal mucosa. Caudal portion was excised using endo-GIA stapler. Partial Dor fundoplication performed afterwards.Asymptomatic at 2 months
Roshe et al. [9]45MDistal esophagusDysphagia for 6  weeksLeft thoracoabdominal esophagogastrectomyAsymptomatic
Razi [7]43MDistal esophagusMassive upper GI bleedingThoracotomy for removal of the pleural over the esophagus; tumor was enucleated from the esophageal wallAsymptomatic
Salo et al. [6]25MDistal esophagusNonspecific upper abdominal discomfort, heartburn, and vomiting for 1  year preoperatively. 3  years postoperatively, EGD showed reflux esophagitis.Intramural esophageal cyst was enucleated by right thoracotomy. Reflux was treated with metoclopramide and ranitidine.N/A
Shalaby et al. [16]52MMass located at GEJEpisodic dysphagiaSmall food bolusesAsymptomatic
Guillou et al. [8]60MUlcerated mass located at GEJEpigastric pain, dysphagia, and weight loss.Tumor resection by left thoracotomy with proximal stomach resection; esophagogastric anastomosisAsymptomatic at first but then developed bronchopneumonia and died 3 months postoperatively
Rodriguez et al. [11]41FSubmucosal mass found at GEJ extending into lesser curvature of stomachDysphagia and epigastric painTotal gastrectomy with Roux-en-Y esophagojejunostomyN/A
Garn et al. [14]38FSubmucosal tumor of GEJGERDEndoscopically assisted laparoscopic resectionAsymptomatic
Salim et al. [18]29MIrregularity of Z-line in distal esophagusEpigastric pain radiating to the chest, worsened by hunger. Dysphagia to solids.N/AN/A

GEJ: gastroesophageal junction; IPMN: intraductal papillary mucinous neoplasm; SOB: shortness of breath; RUQ: right upper quadrant; VATS: video-assisted thoracoscopic surgery; ILE: Ivor-Lewis esophagectomy; GI: gastrointestinal; GERD: gastroesophageal reflux disease.