Pancréas ectopique de localisation hépatique

Ectopic pancreas (or aberrant or pancreatic heterotopia) is defined as pancreatic tissue outside the boundaries of the pancreas, without anatomic connection to the main gland. Its incidence is between 0.5% and 14% in autopsy series, but it is probably underestimated because it is often asymptomatic. It most commonly affects the duodenum (30-35%), the stomach (30%), and the jejunum (15%). Hepatic involvement is exceptional. We here report a new case of unexpected detection. The study involved a 54-year-old, hypertense female patient who had undergone surgery for adenocarcinoma of the sigmoid classified pT3N1b (A) two years before. Disease progression was marked by the occurrence of multiple predominant secondary nodules in the right hepatic lobe (B). Neoadjuvant chemotherapy (4 cicles of FOLFOX-ERBITUX) was started. The patient received right lobectomy. The histological examination of the different surgical specimens confirmed the presence of secondary, moderately differentiated hepatic adenocarcinoma of colorectal origin with healthy surgical excision margins. The surrounding liver was the site of unsystematized macrovacuolar steatosis in 20% of cases. It was associated with a focus of pancreatic heterotopia, including some acini and excretory canals arranged in lobules (C, D). The postoperative course was simple; however, patient’s outcome was marked by recurrence of cancer in the left lobe of the liver.