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Open Access Case Report

Ectopic pancreatic pseudocyst and cyst presenting as a cervical and mediastinal mass - case report and review of the literature

Ariel Rokach1, Gabriel Izbicki1*, Maher Deeb2, Naama Bogot3, Nissim Arish1, Irith Hadas-Halperen3, Hava Azulai1, Abraham Bohadana1 and Eli Golomb4

Author Affiliations

1 The Institute of Pulmonology, Shaare Zedek Medical Center, Jerusalem, Israel

2 Department of Cardiothoracic Surgery, Shaare Zedek Medical Center, Jerusalem, Israel

3 Department of Radiology, Shaare Zedek Medical Center, Jerusalem, Israel

4 Institute of Pathology Shaare Zedek Medical Center, Jerusalem, 91031, Israel

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Diagnostic Pathology 2013, 8:176  doi:10.1186/1746-1596-8-176

Published: 23 October 2013

Abstract

Ectopic pancreas in the mediastinum is extremely rare. We are reporting on a case of a twenty two year old woman who presented to our clinic with a large cervical mass. The CT scan revealed a cystic lesion in the anterior mediastinum. The patient underwent surgical resection by cervical approach. A Cystic mass with pseudocysts, cysts and complete pancreatic tissue were found in pathology. There were no signs of pancreatitis or malignancy. No recurrence was observed after a follow up of four years. We reviewed the case reports describing this rare condition in the medical literature.

We conclude that the possibility of ectopic pancreatic tissue should be included in the differential diagnosis of anterior mediastinal cystic mass, though as a remote possibility. Surgery is probably needed for the diagnosis and treatment. Posterior mediastinal pseudocyst is a different entity associated with acute pancreatitis. In those cases surgery is not recommended. Our third conclusion is that pancreatic tissue should be actively sought, if a structure resembling a pseudocyst is found in an unexpected location.

Virtual slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1849369005957671 webcite

Keywords:
Ectopic pancreas; Mediastinum; Computed tomography; Pseudocyst; Cyst