Overview of ectopic pancreas

This editorial discusses the article written by Zheng et al that was published in the latest edition of the World Journal of Gastrointestinal Surgery. Our primary focus is on the causes, location, diagnosis, histological classification, and therapy of ectopic pancreas. Ectopic pancreas refers to the presence of pancreatic tissue that is situated in a location outside its usual anatomical placement, and is not connected to the normal pancreas in terms of blood supply or anatomical structure. Currently, the embryological origin of ectopic pancreas remains uncertain. The most prevalent form of ectopic pancreatic is gastric ectopic pancreas. Endoscopic ultrasonography examination can visualize the morphological characteristics of the ectopic pancreatic lesion and pinpoint its anatomical location. The histological categorization of ectopic pancreas evolves. Endoscopic treatment has been widely advocated in ectopic pancreas.

CT differentiation of gastric ectopic pancreas from gastric stromal tumor

Background

Gastric ectopic pancreas (GEPs) is a rare developmental anomaly which is difficult to differentiate it from submucosal tumor such as gastric stromal tumor (GST) by imaging methods. Since the treatments of the GEPs and GST are totally different, a correct diagnosis is essential. Therefore, we retrospectively investigated the CT features of them to help us deepen the understanding of GEPs and GST.

Methods

This study enrolled 17 GEPs and 119 GST, which were proven pathologically. We assessed clinical and CT features to identify significant differential features of GEPs from GST using univariate and multivariate analyses.

Results

In univariate analysis, among all clinicoradiologic features, features of age, symptom, tumor marker, location, contour, peritumoral infiltration or fat-line of peritumor, necrosis, calcification, CT attenuation value of unenhancement phase/arterial phase/portal venous phase (CTu/CTa/CTp), the CT attenuation value of arterial phase/portal venous phase minus that of unenhanced phase (DEAP/DEPP), long diameter (LD), short diameter (SD) were considered statistically significant for the differentiation of them. And the multivariate analysis revealed that location, peritumoral infiltration or fat-line of peritumor, necrosis and DEPP were independent factors affecting the identification of them. In addition, ROC analysis showed that the test efficiency of CTp was perfect (AUC = 0.900).

Conclusion

Location, the presence of peritumoral infiltration or fat-line of peritumor, necrosis and DEPP are useful CT differentiators of GEPs from GST. In addition, the test efficiency of CTp in differentiating them was perfect (AUC = 0.900).