A 46-year-old woman with dyspepsia of several years of evolution that did not improve with medical-dietetic treatment.
Endoscopy revealed a submucosal lesion of 1 cm in diameter located in the posterior aspect of the gastric antrum without signs of ulceration.
The biopsy is suggestive of moderate congestion and focal edema of the lamina propria.
Antral, gastrointestinal transit (GIT) and computed tomography (CT) showed a filling defect with loss of mucous folds compatible with a previously described tumor.
During follow-up, several echoendoscopies (EE) were performed, showing a homogeneous hypoechoic lesion, with regular margins, which seems to depend on the muscular layer, 2 x 1.6 cm tumor with soft consistency.
No significant lymphadenopathies.
FNAC: epithelial celliad without malignancy.
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The increased size of the lesion, the persistence of symptoms, the absence of a definitive diagnosis and the impossibility to rule out malignancy made us consider its surgical removal.
The excision is performed laparoscopically, identifying the lesion by intraoperative endoscopy and staining with Chinese ink prior to surgery.
An anterior gastrostomy was performed and resection was performed with a linear endograpillator of 45 mm (Endo-surgery).
The gastrostomy was then closed by continuous silk suture.
From the macroscopic point of view, the lesion has a solid consistency and the external surface is yellow-white.
The microscopic study identified heterotopic pancreatic tissue with predominance of irregularly dilated ducts.
The postoperative period was uneventful, restarting oral intake on day 4 and being discharged on day 7.
Currently the patient is asymptomatic.
