Key result
Surgical resection resolves acute arrhythmias caused by rare mediastinal ectopic pancreatic tissue.
Why the study?
Ectopic pancreatic tissue presenting as a large anterior mediastinal mass is exceedingly rare and poses a significant diagnostic challenge mimicking common malignancies.
Case Report (n=1)
No
This case highlights that ectopic pancreatic tissue should be considered as a rare differential for a necrotic anterior mediastinal mass, which can cause significant mass effect and inflammation leading to secondary cardiac arrhythmias.
Consider ectopic pancreatic tissue in necrotic mediastinal mass differentials with arrhythmias; extends pathology spectrum but leaves broader implications open.
Ectopic pancreatic tissue presenting as large anterior mediastinal mass is exceedingly rare and poses a significant diagnostic challenge, which could mimic common malignancies such as thymoma, teratoma or lymphoma. We report a case of a 49-year-old female who presented with pleuritic chest pain, new-onset atrial fibrillation with rapid ventricular response and nonsustained ventricular tachycardia. Computer tomography pulmonary angiogram (CTPA) identified a large peripherally enhancing anterior mediastinal mass with extensive central necrosis. The lesion exerted a significant mass effect, compressing the pulmonary trunk and displacing the ascending aorta. Initial CT-guided core biopsy was nondiagnostic, yielding only necrotic debris and neutrophils. Given the diagnostic uncertainty and the patient's worsening symptoms, a surgical biopsy via a Chamberlain procedure was performed, revealing thick, black necrotic fluid with histology confirming ectopic pancreatic tissue. This case demonstrates ectopic pancreatic tissue as a rare differential of a necrotic anterior mediastinal mass. Early recognition is vital to guide appropriate surgical management and prevent morbidity related to pancreatic enzymatic action on surrounding key anatomical structures and the misdiagnosis of more common mediastinal neoplasms.
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Quan et al. (2026) conducted a case report in Ectopic pancreatic tissue as anterior mediastinal mass (n=1). Surgical biopsy and definitive resection was evaluated. Ectopic pancreatic tissue can rarely present as a large necrotic anterior mediastinal mass, mimicking malignancy and causing acute arrhythmias that resolve following definitive surgical resection.
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