Case Report

Endometriosis of the Pancreas Presenting as a Cystic Pancreatic Neoplasm with Possible Metastasis

Authors: Anuradha Tunuguntla, MD, Nancy Van Buren, MD, Mack R. Mathews, MD, John A. Ehrenfried, MD

Abstract

The authors report a case of endometriosis that presented as a cystic mass in the tail of the pancreas, leading to extensive evaluation and ultimately a major surgical resection. The diagnosis was made by histopathological evaluation, revealing endometrial glands and stroma in the wall of the mass with hemorrhagic fluid in the cystic lumen, compatible with pancreatic involvement by an endometrial cyst.


Key Points


* Endometriosis involving the pancreas is an extremely rare condition.


* The pathogenic mechanisms of endometriosis in extrapelvic sites are numerous.


* Histopathological demonstration of endometrial tissue in the mass helps confirm the diagnosis.


* In a woman of childbearing age with intermittent abdominal pain and a cystic lesion in the pancreas on imaging studies, endometriosis must be considered in the differential diagnosis.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Craig AW. Current concepts in the pathogenesis of endometriosis. Clin Obstet Gynecol1999;42:566–685.
 
2. Sampson J. Peritoneal endometriosis due to the menstrual dissemination of endometrial tissue into the peritoneal cavity. Am J Obstet Gynecol 1927;14:422–469.
 
3. Sampson JA. Metastatic or embolic endometriosis due to menstrual dissemination of endometrial tissue into the venous circulation. Am J Pathol 1927;3:93–110.
 
4. Javert CJ. Pathogenesis of endometriosis based on endometrial homeoplasia, direct extension, exfoliation and implantation, lymphatic and hematogenous metastasis, including five case reports of endometrial tissue in pelvic lymph nodes. Cancer 1949;2:399–410.
 
5. Takemori M, Sugimura K. Ovarian chocolate cyst with markedly elevated serum CA19–9 level: a case report. Eur J Obstet Gynecol Reprod Biol 1991;42:241–244.