Retrospective clinical analysis of heterotopic pancreas misdiagnosed as gastrointestinal stromal tumors

Objective To improve the differential diagnosis and treatment between heterotopic pancreas and gastrointestinal stromal tumor. Method Clinical and follow-up data of 14 cases who were diagnosed preoperatively as gastrointestinal stromal tumor whereas were confirmed as heterotopic pancreas in the gastrointestinal tract by postoperative pathological results in Renji Hospital from January 2007 to June 2013 were analyzed retrospectively. Result There were 9 males and 5 females, aged ranged from 26 to 69 years old. Eight patients had upper abdominal pain, 2 presented with intestinal obstruction, and 4 were incidentally found on routine health check-up. The lesions located at the stomach in 11 cases, at the duodenum in 1 case, and at the jejunum in 2 cases. All the patients underwent operation. Postoperative pathology confirmed the diagnosis of heterotopic pancreas. Among these lesions, 10 cases presented with co-existence of pancreatic acinus and duct as main component with smooth muscle and few gastric mucosa tissues, 3 cases was mainly the pancreatic acinus and 1 case mainly the pancreatic duct and smooth muscle. Conclusions Heterotopic pancreas may be misrocognized at gastrointestinal stromal tumors due to non-specific clinical manifestations and effective examination methods. Surgical procedure is the only one and the most effective treatment. Postoperative pathology examination is the most difinitive for differential diagnosis. Key words: Gastrointestinal stromal tumors; Heterotopic pancrease; Differential diagnosis