{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:05:26Z","timestamp":1784264726568,"version":"3.55.0"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ectopic pancreas is a congenital developmental anomaly that may occur in the stomach, duodenum, jejunum, and other gastrointestinal sites. Because its clinical, laboratory, and imaging features are often nonspecific, it may mimic gastrointestinal subepithelial tumors, particularly when presenting as a submucosal, intramural, or wall-based mass. Gastrointestinal stromal tumor (GIST) is often an important preoperative differential diagnosis, but it is not the only diagnostic consideration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report two biological sisters with pathologically confirmed ectopic pancreas. Case 1 was the younger sister. She was asymptomatic and was found to have a gastric submucosal lesion and an enhancing small intestinal nodule during a routine health check-up. Gastroscopy, endoscopic ultrasonography, and contrast-enhanced computed tomography suggested a gastrointestinal subepithelial tumor, with GIST considered as the leading preoperative diagnosis, and both lesions were surgically resected. Histopathology confirmed ectopic pancreas at both sites. Case 2 was the elder sister. She presented with right upper abdominal pain radiating to the back, low-grade fever, elevated C-reactive protein, and a proximal jejunal wall-based mass on multimodal imaging. GIST could not be excluded before surgery. Laparoscopic resection was performed, and histopathology confirmed ectopic pancreas with local inflammatory changes.<\/jats:p>\n                    <jats:p>In both cases, the resected lesions showed mature pancreatic acini, ducts, and islets, consistent with Heinrich type I and Gaspar-Fuentes type I ectopic pancreas. Case 1 showed no evidence of recurrence by April 2026. Case 2 had no obvious abdominal symptoms during short-term follow-up until April 2026, but long-term recurrence, symptom control, and postoperative complications could not be fully assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ectopic pancreas may present as gastrointestinal wall-based tumor-like lesions and closely mimic GIST or other gastrointestinal subepithelial tumors on preoperative imaging, particularly when typical features such as central umbilication or duct-like structures are absent. Histopathological examination remains essential for definitive diagnosis. Although both patients were biological sisters, the current evidence is insufficient to support hereditary origin or definite familial clustering.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1903884","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:23:35Z","timestamp":1784262215000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Ectopic pancreas mimicking gastrointestinal subepithelial tumors: diagnostic challenges in two surgically confirmed sibling cases"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaoxia","family":"Li","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine, Haining People\u2019s Hospital","place":["Jiaxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juanxian","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Haining People\u2019s Hospital","place":["Jiaxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianghua","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pathology, Haining People\u2019s Hospital","place":["Jiaxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangliang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Haining People\u2019s Hospital","place":["Jiaxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saiqi","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Second School of Clinical Medicine, Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Haining People\u2019s Hospital","place":["Jiaxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1148\/rg.2017160091","article-title":"Heterotopic pancreas: histopathologic features, imaging findings, and complications.","volume":"37","author":"Rezvani","year":"2017","journal-title":"Radiographics."},{"key":"B2","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1186\/s13244-021-01089-0","article-title":"Insight into gastrointestinal heterotopic pancreas: imaging evaluation and differential diagnosis.","volume":"12","author":"Yang","year":"2021","journal-title":"Insights Imaging."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.3748\/wjg.v28.i14.1455","article-title":"Clinical classification of symptomatic heterotopic pancreas of the stomach and duodenum: a case series and systematic literature review.","volume":"28","author":"LeCompte","year":"2022","journal-title":"World J Gastroenterol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"3701","DOI":"10.3748\/wjg.15.3701","article-title":"Heterotopic pancreas in the gastrointestinal tract.","volume":"15","author":"Yuan","year":"2009","journal-title":"World J Gastroenterol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1695","DOI":"10.3390\/medicina60101695","article-title":"Endoscopic ultrasound and gastric sub-epithelial lesions: ultrasonographic features, tissue acquisition strategies, and therapeutic management.","volume":"60","author":"Varanese","year":"2024","journal-title":"Medicina."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.1111\/j.1440-1746.2011.06764.x","article-title":"Endosonographic findings of gastric ectopic pancreas: a single center experience.","volume":"26","author":"Park","year":"2011","journal-title":"J Gastroenterol Hepatol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1159\/000343093","article-title":"Heterotopic pancreas of the jejunum incidentally detected by preoperative abdominal CT: report of two cases and review of the literature.","volume":"6","author":"Watanabe","year":"2012","journal-title":"Case Rep Gastroenterol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"6349","DOI":"10.12998\/wjcc.v12.i30.6349","article-title":"Advances in the diagnosis and treatment of heterotopic pancreas.","volume":"12","author":"Lang","year":"2024","journal-title":"World J Clin Cases."},{"key":"B9","doi-asserted-by":"publisher","first-page":"45","DOI":"10.14740\/gr1363","article-title":"Gastrointestinal tract heterotopic pancreas: asymptomatic pathology?","volume":"14","author":"Farah","year":"2021","journal-title":"Gastroenterology Res."},{"key":"B10","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1186\/s12893-017-0250-x","article-title":"Clinical impact of duodenal pancreatic heterotopia - 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