Gastric Heterotopic Pancreas Presenting as a Submucosal Tumor in a 27-Year-Old Male.

A 27-year-old male presented with intermittent dark, loose stools and fatigue, dizziness, and palpitations for 2 weeks. On exam, he was tachycardic with pale mucous membranes. Lab tests indicated normocytic anemia with hemoglobin of 5.4 g/dL. A positive fecal occult blood test suggested gastrointestinal bleeding as the cause of anemia. Esophagogastroduodenoscopy revealed a 4 x 5-cm firm subepithelial mass along the greater curvature of the distal gastric body with a large ulceration suspicious for gastrointestinal stromal tumor (GIST; Figure 1). There was no active bleeding and the remaining stomach and duodenum was normal. Laparoscopic partial gastrectomy was performed. Pathologic examination of the mass revealed pancreatic heterotopia displaying acinar cells in the midst of gastric mucosa with overlying ductal cells, negative for malignancy, with clear margins of resection (Figure 2). He recovered uneventfully and was discharged with no further intervention.