{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T17:04:44Z","timestamp":1754154284496,"version":"3.41.2"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["202140515"],"award-info":[{"award-number":["202140515"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Ectopic pancreas (EP) is most commonly located in the upper gastrointestinal tract, particularly in the stomach. Malignant transformation of EP is exceptionally rare, and due to its very low incidence, the response to drug therapy and overall prognosis remain poorly understood. This report presents a case of gastric ectopic pancreatic ductal adenocarcinoma. Unusually, the patient also had concurrent endometriosis, which caused the tumor to resemble advanced cancer on imaging. Although over 50 cases of malignant transformation of EP have been documented. Nevertheless, it has not been definitively established which drug therapeutic regimens is effective for this disease. This is the first to detail the tumor\u2019s response to anti-tumor drug therapy. Pancreatic cancer is generally resistant to anti-tumor drugs. However, in this case, the tumor arising from EP regressed following treatment with immune checkpoint inhibitors (ICIs) combined with chemotherapy. This observation highlights differences in the biological behavior of these two tumor types.<\/jats:p>","DOI":"10.3389\/fonc.2025.1573622","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T04:10:54Z","timestamp":1753330254000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Gastric ectopic pancreatic ductal adenocarcinoma coexisted with endometriosis mimick advanced disease: a case report and literature review"],"prefix":"10.3389","volume":"15","author":[{"given":"Jingwen","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiayan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1242\/dev.121.6.1569","article-title":"Developmental biology of the pancreas","volume":"121","author":"Slack","year":"1995","journal-title":"Development"},{"key":"B2","doi-asserted-by":"publisher","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":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-018-5366-z","article-title":"Malignant transformation of ectopic pancreas","volume":"64","author":"Cazacu","year":"2019","journal-title":"Dig Dis Sci"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000850","article-title":"Heterotopic pancreas of the gastrointestinal tract and associated precursor and cancerous lesions: systematic pathologic studies of 165 cases","volume":"41","author":"Jun","year":"2017","journal-title":"Am J Surg Pathol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i34.5720","article-title":"Laparoscopic-endoscopic cooperative surgery for gastric submucosal tumors","volume":"19","author":"Kang","year":"2013","journal-title":"World J Gastroenterol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-014-2708-9","article-title":"Preoperative predictive factors for gastrointestinal stromal tumors: analysis of 375 surgically resected gastric subepithelial tumors","volume":"19","author":"Min","year":"2015","journal-title":"J Gastrointest Surg"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1111\/den.12854","article-title":"Endoscopic ultrasonography diagnosis of subepithelial lesions","volume":"29","author":"Kida","year":"2017","journal-title":"Dig Endosc"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2019.03.025","article-title":"EUS-guided core biopsies of pancreatic solid masses using a new fork-tip needle: A multicenter prospective study","volume":"51","author":"Di Leo","year":"2019","journal-title":"Dig Liver Dis"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/01.sle.0000166991.05099.b4","article-title":"Laparoscopic wedge resection for gastric ectopic pancreas","volume":"15","author":"De Vogelaere","year":"2005","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-004-1601-9","article-title":"Adenocarcinoma arising from aberrant pancreas in the stomach","volume":"40","author":"Matsuki","year":"2005","journal-title":"J Gastroenterol"},{"key":"B11","article-title":"Ectopias pancre\u00e1ticas [Pancreatic ectopias","volume":"39","author":"Gaspar Fuentes","year":"1973","journal-title":"Rev Esp Enferm Apar Dig"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20087","article-title":"Adenocarcinoma arising in association with gastric heterotopic pancreas: A case report and review of the literature","volume":"87","author":"Emerson","year":"2004","journal-title":"J Surg Oncol"},{"key":"B13","article-title":"Ductal adenocarcinoma arising in a heterotopic pancreas situated in a hiatal hernia","volume":"118","author":"Guillou","year":"1994","journal-title":"Arch Pathol Lab Med"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-019-0245-z","article-title":"Rethinking mechanisms, diagnosis and management of endometriosis","volume":"15","author":"Chapron","year":"2019","journal-title":"Nat Rev Endocrinol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0000000000004049","article-title":"Interference of known or suspected endometriosis in reporting FDG PET\/CT performed in another indication","volume":"47","author":"Balogova","year":"2022","journal-title":"Clin Nucl Med"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0000000000001260","article-title":"Endometriosis mimicking an advanced Malignant tumor","volume":"41","author":"Wang","year":"2016","journal-title":"Clin Nucl Med"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0000000000001038","article-title":"Unusual case of postmenopausal diffuse endometriosis mimicking metastastic ovarian Malignancy","volume":"41","author":"Agarwal Sharma","year":"2016","journal-title":"Clin Nucl Med"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.5387\/fms.2022-23","article-title":"A case of polypoid endometriosis mimicking advanced ovarian carcinoma with rapid growth, invasion, and dissemination","volume":"68","author":"Yazawa","year":"2022","journal-title":"Fukushima J Med Sci"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.15386\/mpr-2116","article-title":"PD-1\/PD-L1 expression in pancreatic cancer and its implication in novel therapies","volume":"94","author":"Mucileanu","year":"2021","journal-title":"Med Pharm Rep"},{"key":"B20","doi-asserted-by":"publisher","first-page":"20","DOI":"10.3390\/jpm9020020","article-title":"Inflammation, biomarkers and immuno-oncology pathways in pancreatic cancer","volume":"9","author":"Lee","year":"2019","journal-title":"J Pers Med"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01366-1","article-title":"NALIRIFOX versus nab-paclitaxel and gemcitabine in treatment-naive patients with metastatic pancreatic ductal adenocarcinoma (NAPOLI 3): a randomised, open-label, phase 3 trial","volume":"402","author":"Wainberg","year":"2023","journal-title":"Lancet"},{"key":"B22","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/S0140-6736(21)00797-2","article-title":"First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): a randomised, open-label, phase 3 trial","volume":"398","author":"Janjigian","year":"2021","journal-title":"Lancet"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.28463","article-title":"First-line sugemalimab plus chemotherapy for advanced gastric cancer: the GEMSTONE-303 randomized clinical trial","volume":"333","author":"Zhang","year":"2025","journal-title":"JAMA"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.19918","article-title":"Sintilimab plus chemotherapy for unresectable gastric or gastroesophageal junction cancer: the ORIENT-16 randomized clinical trial","volume":"330","author":"Xu","year":"2023","journal-title":"JAMA"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(23)00515-6","article-title":"KEYNOTE-859 investigators. Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for HER2-negative advanced gastric cancer (KEYNOTE-859): a multicentre, randomised, double-blind, phase 3 trial","volume":"24","author":"Rha","year":"2023","journal-title":"Lancet Oncol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1573622\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T04:10:55Z","timestamp":1753330255000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1573622\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,24]]},"references-count":25,"alternative-id":["10.3389\/fonc.2025.1573622"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1573622","relation":{},"ISSN":["2234-943X"],"issn-type":[{"type":"electronic","value":"2234-943X"}],"subject":[],"published":{"date-parts":[[2025,7,24]]},"article-number":"1573622"}}