BACKGROUND:Cystic dystrophy in heterotopic pancreas (CDHP)is a rare benign condition characterized by the presence of cysts in the wall of the digestive tract associated with inflammation and fibrosis,intermingled wit...BACKGROUND:Cystic dystrophy in heterotopic pancreas (CDHP)is a rare benign condition characterized by the presence of cysts in the wall of the digestive tract associated with inflammation and fibrosis,intermingled with heterotopic pancreatic tissue.Treatment options for CDHP are poorly defined. METHOD:We report a case of CDHP,and review the literature focusing on the diagnosis and management. RESULTS:CDHP is mainly encountered in men in the fifth decade of life in association with chronic pancreatitis secondary to alcohol ingestion.Alcohol and mechanical obstruction of heterotopic pancreatic ducts have been implicated in its pathogenesis.Clinical presentation is varied and current imaging provides the diagnosis. Treatment options include somatostatin analogue injections, endoscopic cyst fenestration and surgical resection (pancreaticoduodenectomy or gastrointestinal bypass). CONCLUSION:CDHP is rare and presents a diagnostic and therapeutic challenge.The long term efficacy and indications for different treatment options need to be refined.展开更多
BACKGROUND:Neuroendocrine tumors(NETs)arising in the biliary tree are extremely rare,and 37 cases were identified in the English literature. METHODS:A well-differentiated NET was found arising from the junction of the...BACKGROUND:Neuroendocrine tumors(NETs)arising in the biliary tree are extremely rare,and 37 cases were identified in the English literature. METHODS:A well-differentiated NET was found arising from the junction of the cystic and common hepatic ducts, in a 51-year-old male presenting with pedal edema and weight loss with abnormal liver enzymes and a normal serum bilirubin level.No mass was seen on radiological imaging and biopsy of the liver was suggestive of an early cholangiopathy.A bile leak complicating the liver biopsy led to an ERCP that demonstrated a filling defect suggestive of a mass in the common bile duct(CBD). RESULTS:He underwent a successful excision of the tumor with a Roux-en-Y hepaticojejunostomy.The diagnosis of NET was made on histological and immunohistochemical analysis of the resected specimen.He remains well and disease free 22 months after surgery. CONCLUSIONS:Recognition of biliary NET continues to be a challenge and an increased awareness of these tumors in rare sites will result in optimal management of these tumors.展开更多
文摘BACKGROUND:Cystic dystrophy in heterotopic pancreas (CDHP)is a rare benign condition characterized by the presence of cysts in the wall of the digestive tract associated with inflammation and fibrosis,intermingled with heterotopic pancreatic tissue.Treatment options for CDHP are poorly defined. METHOD:We report a case of CDHP,and review the literature focusing on the diagnosis and management. RESULTS:CDHP is mainly encountered in men in the fifth decade of life in association with chronic pancreatitis secondary to alcohol ingestion.Alcohol and mechanical obstruction of heterotopic pancreatic ducts have been implicated in its pathogenesis.Clinical presentation is varied and current imaging provides the diagnosis. Treatment options include somatostatin analogue injections, endoscopic cyst fenestration and surgical resection (pancreaticoduodenectomy or gastrointestinal bypass). CONCLUSION:CDHP is rare and presents a diagnostic and therapeutic challenge.The long term efficacy and indications for different treatment options need to be refined.
文摘BACKGROUND:Neuroendocrine tumors(NETs)arising in the biliary tree are extremely rare,and 37 cases were identified in the English literature. METHODS:A well-differentiated NET was found arising from the junction of the cystic and common hepatic ducts, in a 51-year-old male presenting with pedal edema and weight loss with abnormal liver enzymes and a normal serum bilirubin level.No mass was seen on radiological imaging and biopsy of the liver was suggestive of an early cholangiopathy.A bile leak complicating the liver biopsy led to an ERCP that demonstrated a filling defect suggestive of a mass in the common bile duct(CBD). RESULTS:He underwent a successful excision of the tumor with a Roux-en-Y hepaticojejunostomy.The diagnosis of NET was made on histological and immunohistochemical analysis of the resected specimen.He remains well and disease free 22 months after surgery. CONCLUSIONS:Recognition of biliary NET continues to be a challenge and an increased awareness of these tumors in rare sites will result in optimal management of these tumors.
