Heterotopic pancreatic cyst in the adrenal gland A case report and review of literature

Rationale: The incidence of heterotopic pancreas (HP) is relatively rare and mainly found in the upper gastrointestinal tract, and no case of HP cyst in the adrenal gland has been reported. Informed consent has been obtained from the patient for the publication of the case details. Patient concerns: A 21-year-old woman who presented with chronic lower back pain for a week without urinary disturbance or gastrointestinal discomfortable. Diagnoses: Ultrasound (US) revealed a left renal cyst, and computed tomography (CT) showed a cyst in the area of the adrenal gland. Interventions: Cystectomy was successfully performed laparoscopically. Histopathologic examination of the removed cyst wall showed heterotopic pancreatic cyst accompanied by cystic degeneration. Outcomes: No unusual drainage or abdominal signs were observed during the 6-month follow-up. Lessons: Despite of its rarity, HP accompanied by cyst formation in the adrenal gland area can present with waist pain. Therefore, the possibility of such disease needs to be considered. For thorough evaluation, in addition to abdominal US, CT, and/or magnetic resonance imaging, histopathological examination should sometimes be performed to make a definite diagnosis. Total excision and regular follow-up is necessary for such cases due to the potential risk of complications or recurrent cyst formation.