PMC7503788_01
a) Endoscopic findings at 5 years prior. A subepithelial mass with smooth surface measuring 4.0 x 3.0 cm is visible on the posterior wall of the distal antrum. b) A subepithelial mass measuring 4.0 x 3.0 cm at the same site. Erythematous discoloration with erosion is visible on the surface of the mass.
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Five years prior, the tumour was documented to be the same size as it was originally (Fig. 1a). In our physical examination, EGD revealed that the submucosal tumour had erythematous mucosa and erosion measuring 40 mm in diameter on the posterior wall of the gastric angle (Fig. 1b).
a) Contrast-enhanced computed tomography scan of the portal phase showing a round mass with multiple cystic lesions on the lesser curvature of the stomach. b) Endoscopic ultrasound image showing multiple cystic formation located in the third layer of the gastric wall. c) Magnetic resonance T2-weighted image showed a hypointense mass with hyperintense multiple cystic lesions.
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Contrast-enhanced computed tomography revealed multiple cystic lesions with wall thickening on the lesser curvature of the stomach (Fig. 2a). Endoscopic ultrasonography (EUS) showed multiple cystic formation within the third layer of the gastric wall (Fig. 2b). No mural nodule or solid component was detected in any of the cysts (Fig. 2c).
Pathological findings. a) Tumour specimen. b) Hematoxylin and eosin staining revealing a heterotopic pancreas with multiple dilated cysts lined by columnar epithelium (original magnification, x10). c) Pancreatic lobules with acini (white arrow), ducts (black arrow), and islets of Langerhans cells (black triangle) (original magnification, x100). d) Periductal chronic inflammation with some dense fibrous tissue and lymphocyte invasion indicative of chronic inflammation (white triangle) but no acute inflammation such as pancreatitis (original magnification, x100).
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Macroscopically, the resected specimen showed a tumour (40 x 30 mm) covered with smooth gastric epithelial mucosa (Fig. 3a). The cystic components were retention cysts that consisted of dilated pancreatic ducts without malignancy (Fig. 3c). Periductal chronic inflammation with some dense fibrous tissue and lymphocyte invasion indicated chronic inflammation but no acute inflammation like pancreatitis (Fig. 3d).