In endometriosis, the tissue similar to that found in the inner lining of the uterus — the endometrium — grows outside the uterus, forming lesions. These lesions are usually found under the uterus, in the ovaries, and in the fallopian tubes. In about 40 percent of endometriosis patients, the endometrium-like tissue forms lesions in organs outside the pelvic regions, such as the pancreas. However, pancreatic endometriosis is extremely rare. According to a recent review of published studies, only 13 cases have been reported since 1984.
About the pancreas
The pancreas is an organ that sits deep in the abdominal cavity, between the stomach and the spine. It produces digestive enzymes responsible for breaking down food. Specifically, the pancreas produces insulin and glucagon that are released into the bloodstream to maintain blood sugar levels.
Symptoms of pancreatic endometriosis
The common symptoms of pancreatic endometriosis include:
- Unexplained weight loss
- Pain below the ribs (epigastric pain)
- Pain on the left side of the body in the area between the stomach and chest
- Nausea and vomiting
- Diarrhea
- Mass in the left upper abdomen
- Inflammation of the pancreas (pancreatitis)
- Fatigue
Diagnosis of pancreatic endometriosis
Imaging studies such as computerized tomography and magnetic resonance imaging can be beneficial in the diagnosis of pancreatic endometriosis. However, they may not be sensitive enough to differentiate between endometriosis and cancer.
Microscopic analysis of a piece of pancreatic tissue (biopsy) can help determine the nature of the lesions.
Treatment
The pain symptoms of pancreatic endometriosis may be managed using pain relief medications and hormone therapy. However, their effectiveness may vary based on the severity of the condition.
The imaging results of pancreatic endometriosis may often be unclear because of the similarity between the endometrial cyst and pancreatic cancer such as mucinous cystic pancreatic neoplasms. If biopsy also does not provide a clear answer, it is difficult to rule out whether the nodules or lesions are benign or cancerous. Therefore, surgical intervention to remove the pancreatic tissue and the surrounding structures is recommended.
Last updated: Aug. 5, 2019
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