PRIMARY ADENOCARCINOMA OF ABERRANT PANCREAS IN THE STOMACH DETECTED ON EXAMINATION OF PYLORIC STENOSIS

A 45-year-old man was seen at the hospital because of epigastric pain, nausea and vomiting. Radiography and endoscopy of the upper digestive tract suggested pyloric stenosis. On blood examination, the carbohydrate antigen 19-9 (CA19-9) and gastrin levels increased to 347U/ml, and 829pg/ml, respectively. Distal gastrectomy was performed. Histopathological examination revealed adenocarcinoma cells resembling the epithelium of the pancreatic duct existed betweeen the submucosal and subserosal layers as well as heterotopic pancreas in the focus. On immunohistological staining, the epithelium of the aberrant pancreatic duct as well as the cancer cells were positive for CA19-9. Furthermore, cancer cells were partially positive for gastrin. Therefore, the present case was diagnosed as primary adenocarcinoma of aberrant pancreas in the stomach wall. Carcinoma of aberrant pancreas in the stomach is extremely rare, and only 18 cases have been reported in Japan.