Heterotopic salivary gland tissue in the gastro-oesophageal junction: a rare entity

Abstract

Introduction: Gastric and pancreatic heterotopia are the two most common types of heterotopias seen in the gastrointestinal tract (GIT). These are the two most common types of heterotopias seen in the oesophagus as well. The occurrence of heterotopic salivary gland tissue (HSGT) in the GIT is rare, and most reported cases are colorectal and anal lesions with only a few cases involving the oesophagus. Case report: A 69-year-old man presented with a seven-month history of gastro-oesophageal reflux disease (GORD). The upper gastrointestinal endoscopy showed a moderate hiatus hernia with a pale pink mucosal patch close to the gastro-oesophageal junction. The biopsy showed oesophageal tissue with morphological changes of mild reflux oesophagitis. The submucosal tissue contained organized glandular structures with mucinous glands and intercalated ducts resembling mature salivary gland tissue. There was no evidence of Barrett oesophagus, dysplasia or neoplasm. Discussion and conclusion: HSGT is most commonly seen in the head and neck region of the body, and its occurrence in the GIT is rare. Occurrence of oesophageal HSGT is extremely rare and most cases have presented with symptoms of GORD. Although HSGT is usually benign and a rare phenomenon, clinicians and pathologists need to be aware of this condition to prevent a delay in diagnosis and inappropriate management.