caa a22 4500 606207104 CHVBK 20210128101015.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s10353-015-0326-8 doi (NATIONALLICENCE)springer-10.1007/s10353-015-0326-8 Extensive pancreatic heterotopia in distal esophagus mimicking esophageal malignancy [Elektronische Daten] [T. Grus, S. Trca, L. Lambert, G. Grusova, Z. Kovacova] Summary: Background: We report an unusual and rare case of a young adult patient with extensive symptomatic pancreatic heterotopia in the distal esophagus that appeared on imaging as a malignant tumor. After comprehensive preoperative workup, the soft tissue mass was treated surgically according to intraoperative histology that revealed its benign nature. Methods: A young male patient with worsening epigastric pain, gastroesophageal reflux, and weight loss presented in a university hospital for a comprehensive diagnostic workup. Apart from clinical examination and laboratory tests, he underwent gastroscopy, esophageal manometry, endoscopic ultrasound, barium meal study, computed tomography (CT), and positron emission tomography (PET-CT). Finally an interdisciplinary board recommended surgical removal of a mediastinal mass and final diagnosis was reached by intraoperative histology. Results: The clinical examination and laboratory test were unremarkable, esophageal manometry suggested achalasia due to simultaneous spastic and retrograde contractions with high amplitude. Barium meal showed mild compliant stenosis of the distal esophagus, but gastroscopy found no explanation. CT and later also PET-CT revealed a large soft tissue mass with avid accumulation of 18F-fluorodeoxyglucose surrounding the distal esophagus. Endoscopic ultrasound was very limited and no representative tissue samples were obtained prior to surgery. The surgeon accessed the mediastinum through the left thoracotomy and found a noncompliant well-defined mass surrounding the distal esophagus. Intraoperative histology showed nothing but common structures of pancreatic tissue. Conclusions: A large soft-tissue mass of pancreatic heterotopia in the distal esophatus is extremely rare and preoperative workup inconclusive. Only surgical exploration and (intraoperative) histology are in a position to reveal its true nature. Springer-Verlag Wien, 2015 Pancreatic heterotopia nationallicence Ectopic pancreas nationallicence Esophagus nationallicence Pancreas nationallicence Mediastinum nationallicence Grus T. Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University in Prague, Prague 2, Czech Republic aut Trca S. Department of Surgery, First Faculty of Medicine, Charles University in Prague, Prague 2, Czech Republic aut Lambert L. Department of Radiology, First Faculty of Medicine, Charles University in Prague, U Nemocnice 2, 128 08, Prague 2, Czech Republic aut Grusova G. Fourth Department of Medicine, First Faculty of Medicine, Charles University in Prague, Prague 2, Czech Republic aut Kovacova Z. Institute of Nuclear Medicine, First Faculty of Medicine, Charles University in Prague, Prague 2, Czech Republic aut European Surgery Springer Vienna 47/4(2015-08-01), 206-209 1682-8631 47:4<206 2015 47 10353 https://doi.org/10.1007/s10353-015-0326-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10353-015-0326-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Grus T. Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University in Prague, Prague 2, Czech Republic aut NATIONALLICENCE 700 1- Trca S. Department of Surgery, First Faculty of Medicine, Charles University in Prague, Prague 2, Czech Republic aut NATIONALLICENCE 700 1- Lambert L. Department of Radiology, First Faculty of Medicine, Charles University in Prague, U Nemocnice 2, 128 08, Prague 2, Czech Republic aut NATIONALLICENCE 700 1- Grusova G. Fourth Department of Medicine, First Faculty of Medicine, Charles University in Prague, Prague 2, Czech Republic aut NATIONALLICENCE 700 1- Kovacova Z. Institute of Nuclear Medicine, First Faculty of Medicine, Charles University in Prague, Prague 2, Czech Republic aut NATIONALLICENCE 773 0- European Surgery Springer Vienna 47/4(2015-08-01), 206-209 1682-8631 47:4<206 2015 47 10353