AN UNEXPECTED DIAGNOSIS OF ECTOPIC PANCREAS IN THE LIVER

Faten Limaiem* and Saâdia Bouraoui

ABSTRACT

A 54-year-old hypertensive female patient underwent surgical resection of the sigmoid colon two years ago for a moderately differentiated adenocarcinoma classified as pT3N1b. During the follow-up period, CT scan disclosed multiple metastases predominant in the right hepatic lobe, hence the initiation of neoadjuvant chemotherapy (4 courses FOLFOX - ERBITUX). The patient underwent a right hepatic lobectomy. Histological examination of the different samples taken from the liver confirmed the presence of a secondary hepatic localization of a moderately differentiated adenocarcinoma of colorectal origin with healthy limits of excision. In the surrounding liver there was macrovacuolar steatosis estimated at 20%. In addition, we noted a focus of pancreatic heterotopia including acini and excretory ducts organized in a lobule. The final pathological diagnosis was that of pancreatic heterotopia type II according to Heinrich classification. Postoperative course was uneventful. During the follow-up period, the patient developed liver metastases in the left hepatic lobe. The diagnosis of heterotopic pancreas prior to surgery is difficult due to its non-specific clinical signs and symptoms. Diagnosis can only be established based on histopathological examination.

Keywords: Ectopic pancreas, liver, pathology.