Heterotopic Pancreas in Omphalomesenteric Duct Remnant Results in Persistent Umbilical Discharge

• Published in: Journal of pathology and translational medicine Vol. 48; no. 4; pp. 323 - 326
• Main Authors: Park, Eunhyang, Kim, Hyojin, Jung, Kyu Whan, Chung, Jin-Haeng
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Pathologists, Korean Society for Cytopathology 01.08.2014; The Korean Society of Pathologists and The Korean Society for Cytopathology; 대한병리학회
• Subjects: Brief Case Report; Pancreas; 병리학
• ISSN: 1738-1843; 2383-7837; 2092-8920; 2092-8920; 2383-7845
• DOI: 10.4132/KoreanJPathol.2014.48.4.323

To our knowledge, there have been 13 cases of heterotopic pancreatic tissue in the umbilicus (Table 1).1-4 Various explanations have been offered for heterotopic pan- creas in the umbilicus, but there is no universally accepted the- ory about the cause of this aberrant tissue.5 The three influential pathogeneses include misplacement theory,6 in which embry- onic tissue is located in an inappropriate place and develops into mature pancreatic tissue; metaplasia theory,7 stating that endodermal tissues migrate to the submucosa during embryo- genesis and transform into pancreatic tissue; and the totipotent cell theory,8,9 in which totipotent endodermal cells lining the gut or omphalomesenteric duct differentiate into pancreatic tis- sue. While normal tissue is under the restriction to differentiate into certain cell types, tis- sue in this case seems to escape the normal restriction to main- tain its pluripotent ability. Because preoperative diagnosis is still a challenge, primary treatment for umbilical discharge is silver nitrate application.