Malignant Transformation of Ectopic Pancreas

  • Irina M. Cazacu
  • Adriana Alexandra Luzuriaga Chavez
  • Graciela M. Nogueras Gonzalez
  • Adrian Saftoiu
  • Manoop S. BhutaniEmail author


Malignant transformation of ectopic pancreas tissue is a diagnostic challenge as clinical symptoms and radiographic features of these tumors are non-specific. Given the rarity of these lesions, it is usually neither suspected nor included in the diagnostic workup of different tumors. We conducted a comprehensive literature review regarding malignancy arising from ectopic pancreas for a better understanding of its frequency, clinicopathological features, and prognosis. A literature search was performed in three major databases: PubMed, Cochrane, and Web of Science. Fifty-four well-documented cases of malignant ectopic pancreas were identified in the published literature. Our analysis provided the following observations: (1) there was a slight predominance of males over females; (2) most patients with malignant transformation of ectopic pancreas were middle-aged; (3) most commonly, the tumor was located in the stomach; (4) most tumors were adenocarcinomas; (5) most frequently, the malignancy arose within a type I heterotopia according to Heinrich classification; (6) macroscopically, a subepithelial-like appearance was most frequently observed; and (7) improved prognosis for ectopic pancreatic malignancies in comparison with reported survival data for orthotopic pancreatic cancer. Even if the majority of cases of ectopic pancreas are incidental findings and malignant transformation is a rare event, pancreatic heterotopy should be considered as a source of potentially malignant lesions.


Ectopic pancreas Heterotopic pancreas Ectopic pancreatic cancer, cancer, malignant transformation 



Dr. Irina M. Cazacu is supported by 2017 International Travel Grant offered by the American College of Gastroenterology.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was not applicable to this article type. This is a literature review of all of the cases of malignant ectopic pancreas that have already been published.


  1. 1.
    Goodarzi M, Rashid A, Maru D. Invasive ductal adenocarcinoma arising from pancreatic heterotopia in rectum: case report and review of literature. Hum Pathol. 2010;41:1809–1813.PubMedCrossRefGoogle Scholar
  2. 2.
    Christodoulidis G, Zacharoulis D, Barbanis S, Katsogridakis E, Hatzitheofilou K. Heterotopic pancreas in the stomach: a case report and literature review. World J Gastroenterol WJG. 2007;13:6098.PubMedCrossRefGoogle Scholar
  3. 3.
    Stock C, Keutgen XM, Pisapia D, Crawford C, Zarnegar R. Heterotopic pancreatic neoplasm presenting as an obstructing mass at the fourth portion of the duodenum. JOP J Pancreas. 2011;12:241–243.Google Scholar
  4. 4.
    Ulrych J, Fryba V, Skalova H, et al. Premalignant and malignant lesions of the heterotopic pancreas in the esophagus: a case report and review of the literature. J Gastrointestin Liver Dis. 2015;24:235–239.PubMedGoogle Scholar
  5. 5.
    Chetty R, Weinreb I. Gastric neuroendocrine carcinoma arising from heterotopic pancreatic tissue. J Clin Pathol. 2004;57:314–317.PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Rezvani M, Menias C, Sandrasegaran K, et al. Heterotopic pancreas: histopathologic features, imaging findings, and complications. Radiographics. 2017;37:484–499.PubMedCrossRefGoogle Scholar
  7. 7.
    Yamaoka Y, Yamaguchi T, Kinugasa Y, et al. Adenocarcinoma arising from jejunal ectopic pancreas mimicking peritoneal metastasis from colon cancer: a case report and literature review. Surg Case Rep. 2015;1:114.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    Hickman DM, Frey CF, Carson J. Adenocarcinoma arising in gastric heterotopic pancreas. West J Med. 1981;135:57.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Matsuki M, Gouda Y, Ando T, et al. Adenocarcinoma arising from aberrant pancreas in the stomach. J Gastroenterol. 2005;40:652–656.PubMedCrossRefGoogle Scholar
  10. 10.
    Gaspar Fuentes A, Campos Tarrech JM, Fernandez Burgui JL, et al. Pancreatic ectopias. Rev Esp Enferm Apar Dig. 1973;39:255–268.PubMedGoogle Scholar
  11. 11.
    Guillou L, Nordback P, Gerber C, Schneider RP. Ductal adenocarcinoma arising in a heterotopic pancreas situated in a hiatal hernia. Arch Pathol Lab Med. 1994;118:568–571.PubMedGoogle Scholar
  12. 12.
    Emerson L, Layfield LJ, Rohr LR, Dayton MT. Adenocarcinoma arising in association with gastric heterotopic pancreas: a case report and review of the literature. J Surg Oncol. 2004;87:53–57.PubMedCrossRefGoogle Scholar
  13. 13.
    Goldfarb WB, Bennett D, Monafo W. Carcinoma in heterotopic gastric pancreas. Ann Surg. 1963;158:56.PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Tanimura A, Yamamoto H, Shibata H, Sano E. Carcinoma in heterotopic gastric pancreas. Pathol Int. 1979;29:251–257.CrossRefGoogle Scholar
  15. 15.
    Nakao T. Aberrant pancreas in Japan. Review of the literature and report of 12 surgical cases. Med J Osaka Univ. 1980;30:57–63.PubMedGoogle Scholar
  16. 16.
    Persson G. Cancer of aberrant pancreas in jejunum. Acta Chir Scand. 1988;154:599–601.PubMedGoogle Scholar
  17. 17.
    Bedossa P, Millat B, Zrihen E, Lemaigre G. Adenocarcinoma in heterotopic gastric pancreas. Gastroenterol Clin Biol. 1991;15:79–82.PubMedGoogle Scholar
  18. 18.
    Waku T, Uetsuka H, Watanabe N, et al. A case of mucin-producing duodenal carcinoma arising from the aberrant pancreas. J Jpn Gastroenterol Surg Soc. 1996;29:2289–2293.CrossRefGoogle Scholar
  19. 19.
    Ura H, Denno R, Hirata K, et al. Carcinoma arising from ectopic pancreas in the stomach: endosonographic detection of malignant change. J Clin Ultrasound. 1998;26:265–268.PubMedCrossRefGoogle Scholar
  20. 20.
    Makhlouf HR, Almeida JL, Sobin LH. Carcinoma in jejunal pancreatic heterotopia. Arch Pathol Lab Med. 1999;123:707–711.PubMedGoogle Scholar
  21. 21.
    Arao J, Fukui H, Hirayama D, et al. A case of aberrant pancreatic cancer in the jejunum. Hepato-Gastroenterol. 1999;46:504–507.Google Scholar
  22. 22.
    Osanai M, Miyokawa N, Tamaki T, et al. Adenocarcinoma arising in gastric heterotopic pancreas: clinicopathological and immunohistochemical study with genetic analysis of a case. Pathol Int. 2001;51:549–554.PubMedCrossRefGoogle Scholar
  23. 23.
    Halkic N, Nordback P. Soft-tissue images. Malignant degeneration of heterotopic pancreas. Can J Surg. 2001;44:407–407.Google Scholar
  24. 24.
    Jeong HY, Yang HW, Seo SW, et al. Adenocarcinoma arising from an ectopic pancreas in the stomach. Endoscopy. 2002;34:1014–1017.PubMedCrossRefGoogle Scholar
  25. 25.
    Nam JY, Lee SI, Chung JP, et al. A case of duodenal adenocarcinoma arising from the heterotopic pancreas. Korean J Gastroenterol = Taehan Sohwagi Hakhoe chi. 2003;42:164–167.PubMedGoogle Scholar
  26. 26.
    Kawabata M, Ihara T, Akashi M, et al. A case of ductal carcinoma of the pancreas with sarcomatoid component which might be derived from ectopic pancreas. Nihon Rinsho Geka Gakkai Zasshi (J Jpn Surg Assoc). 2010;71:201–207.CrossRefGoogle Scholar
  27. 27.
    Tison C, Leborgne J. Cystic dystrophy of heterotopic duodenal pancreas. J Chir (Paris). 2001;138:205–214.Google Scholar
  28. 28.
    Yoshida T, Umemoto A, Yamai H, et al. A case of adenocarcinoma arising from the gastric ectopic pancreas. Jpn J Gastroenterol Surg. 2007;40:1576–1581.CrossRefGoogle Scholar
  29. 29.
    Kimura J, Kaji M, Yamamoto S-I, et al. A case of adenocarcinoma arising from ectopic gastric pancreas with carcinomatous peritonitis. Jpn J Gastroenterol Surg. 2008;41:399–405.CrossRefGoogle Scholar
  30. 30.
    Fujita K, Hirakawa K, Matsumoto T, et al. Small-intestinal cancer arising from heterotopic pancreas. Endoscopy. 2008;40:E240–E241.PubMedCrossRefGoogle Scholar
  31. 31.
    Koh HC, Page B, Black C, et al. Ectopic pancreatic-type malignancy presenting in a Meckel’s diverticulum: a case report and review of the literature. World J Surg Oncol. 2009;7:54.PubMedPubMedCentralCrossRefGoogle Scholar
  32. 32.
    Bini R, Voghera P, Tapparo A, et al. Malignant transformation of ectopic pancreatic cells in the duodenal wall. World J Gastroenterol. 2010;16:1293–1295.PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Fukumori D, Matsuhisa T, Taguchi K, Minato M. Ectopic gastric pancreatic cancer: report of a case. Hepato-Gastroenterol. 2011;58:740–744.Google Scholar
  34. 34.
    Stock C, Keutgen XM, Pisapia D, Crawford C, Zarnegar R. Heterotopic pancreatic neoplasm presenting as an obstructing mass at the fourth portion of the duodenum. Jop. 2011;12:241–243.PubMedPubMedCentralGoogle Scholar
  35. 35.
    Song JY, Han JY, Choi SK, et al. Adenocarcinoma with intraductal papillary mucinous neoplasm arising in jejunal heterotopic pancreas. Korean J Pathol. 2012;46:96–100.PubMedPubMedCentralCrossRefGoogle Scholar
  36. 36.
    Kinoshita H, Yamaguchi S, Shimizu A, et al. Adenocarcinoma arising from heterotopic pancreas in the duodenum. Int Surg. 2012;97:351–355.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Yan ML, Wang YD, Tian YF, Lin Y. Adenocarcinoma arising from intrahepatic heterotopic pancreas: a case report and literature review. World J Gastroenterol. 2012;18:2881–2884.PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    Romain PS, Muehlebach G, Damjanov I, Fan F. Adenocarcinoma arising in an ectopic mediastinal pancreas. Ann Diagn Pathol. 2012;16:494–497.CrossRefGoogle Scholar
  39. 39.
    Ginori A, Vassallo L, Butorano M, et al. Pancreatic adenocarcinoma in duodenal ectopic pancreas: a case report and review of the literature. Pathologica. 2013;105:56–58.PubMedGoogle Scholar
  40. 40.
    Endo S, Saito R, Ochi D, et al. Effectiveness of an endoscopic biopsy procedure using EUS-FNA and EMR-C for diagnosing adenocarcinoma arising from ectopic pancreas: two case reports and a literature review. Intern Med. 2014;53:1055–1062.PubMedCrossRefGoogle Scholar
  41. 41.
    Mehra R, Pujahari AK, Jaiswal SS. Duodenal heterotopic pancreatic tissue: a case report and literature review. Gastroenterol Rep. 2015;3:262–265.CrossRefGoogle Scholar
  42. 42.
    Fukino N, Oida T, Mimatsu K, Kuboi Y, Kida K. Adenocarcinoma arising from heterotopic pancreas at the third portion of the duodenum. World J Gastroenterol. 2015;21:4082–4088.PubMedPubMedCentralCrossRefGoogle Scholar
  43. 43.
    Priyathersini N, Sundaram S, Senger JL, et al. Malignant Transformation in gastric pancreatic heterotopia a case report and review of the literature. J Pancreas. 2017;18:73–77.Google Scholar
  44. 44.
    Okamoto H, Kawaoi A, Ogawara T, Fujii H. Invasive ductal carcinoma arising from an ectopic pancreas in the gastric wall: a long-term survival case. Case Rep Oncol. 2012;5:69–73.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Safi F, Schlosser W, Falkenreck S, Beger HG. Prognostic value of CA 19-9 serum course in pancreatic cancer. Hepatogastroenterology. 1998;45:253–259.PubMedGoogle Scholar
  46. 46.
    Tsugu H, Oshiro S, Kawaguchi H, et al. Nonfunctioning endocrine tumor arising from intracranial ectopic pancreas associated with congenital brain malformation. Childs Nerv Syst. 2007;23:1337–1340.PubMedCrossRefGoogle Scholar
  47. 47.
    Tolentino LF, Lee H, Maung T, et al. Islet cell tumor arising from a heterotopic pancreas in the duodenal wall with ulceration. Exp Mol Pathol. 2004;76:51–56.PubMedCrossRefGoogle Scholar
  48. 48.
    Hennings J, Garske U, Botling J, Hellman P. Malignant insulinoma in ectopic pancreatic tissue. Dig Surg. 2005;22:377–379.PubMedCrossRefGoogle Scholar
  49. 49.
    Nisar PJ, Zaitoun AM, Lobo DN, Rowlands BJ. Heterotopic pancreas in the spleen: malignant degeneration to mucinous cystadenocarcinoma. Eur J Gastroenterol Hepatol. 2002;14:793–796.PubMedCrossRefGoogle Scholar
  50. 50.
    Zanetti G, Riccioni L, Gallo C, Salfi N, Martinelli GN. Splenic mucinous cystadenocarcinoma arising in heterotopic pancreatic tissue. Tumori. 1998;84:606–610.PubMedCrossRefGoogle Scholar
  51. 51.
    Mibayashi Y, Ishikawa Y, Takegawa A, et al. Carcinoma originating from the heterotopic pancreas in the stomach: report of a case. Ito Cho. 1983;18:267–272.Google Scholar
  52. 52.
    Ishikawa O, Ishiguro S, Ohhigashi H, et al. Solid and papillary neoplasm arising from an ectopic pancreas in the mesocolon. Am J Gastroenterol. 1990;85:597–601.PubMedGoogle Scholar
  53. 53.
    Tornoczky T, Kalman E, Jakso P, et al. Solid and papillary epithelial neoplasm arising in heterotopic pancreatic tissue of the mesocolon. J Clin Pathol. 2001;54:241–245.PubMedPubMedCentralCrossRefGoogle Scholar
  54. 54.
    Kiriyama Y, Tsukamoto T. Intrahepatic peribiliary perivascular epithelioid cell tumor (PEComa) associated with heterotopic pancreas: a case report. Diagn Pathol. 2016;11:81.PubMedPubMedCentralCrossRefGoogle Scholar
  55. 55.
    Roshe J, Buono ED, Domenico D, Colturi TJ. Anaplastic carcinoma arising in ectopic pancreas located in the distal esophagus. J Clin Gastroenterol. 1996;22:242–244.PubMedCrossRefGoogle Scholar
  56. 56.
    Tong L, Pan H, He J, Weng M, Zheng L. Hepatoid adenocarcinoma arising from heterotopic pancreas of the ileum. Medicine (United States). 2016;95:e4067.Google Scholar
  57. 57.
    Yang ZH, Gao JB, Yue SW, Yang XH, Guo H. Synchronous ectopic pancreatoblastoma in a child: a case report. J Korean Med Sci. 2011;26:832–835.PubMedPubMedCentralCrossRefGoogle Scholar
  58. 58.
    Bookman MR. Carcinoma in the Duodenum: originating from aberrant pancreatic cells. Ann Surg. 1932;95:464.PubMedPubMedCentralCrossRefGoogle Scholar
  59. 59.
    Duff GL, Foster H, Bryan WW. Primary carcinoma of the infra-ampullary portion of the duodenum: with example of probable origin from aberrant pancreatic tissue. Arch Surg. 1943;46:494–503.CrossRefGoogle Scholar
  60. 60.
    Klöppel G, Maurer R, Hofmann E, et al. Solid-cystic (papillary-cystic) tumours within and outside the pancreas in men: report of two patients. Virchows Archiv A. 1991;418:179–183.CrossRefGoogle Scholar
  61. 61.
    Jeng KS, Yang KC, Kuo SH. Malignant degeneration of heterotopic pancreas. Gastrointest Endosc. 1991;37:196–198.PubMedCrossRefGoogle Scholar
  62. 62.
    Ashida K, Egashira Y, Tutumi A, et al. Endocrine neoplasm arising from duodenal heterotopic pancreas: a case report. Gastrointest Endosc. 1997;46:172–176.PubMedCrossRefGoogle Scholar
  63. 63.
    Moncur JT, Lacy BE, Longnecker DS. Mixed acinar-endocrine carcinoma arising in the ampulla of Vater. Hum Pathol. 2002;33:449–451.PubMedCrossRefGoogle Scholar
  64. 64.
    Fukunaga M. Gastric carcinoma resembling pancreatic mixed acinar-endocrine carcinoma. Hum Pathol. 2002;33:569–573.PubMedCrossRefGoogle Scholar
  65. 65.
    Song DE, Kwon Y, Kim KR, Oh ST, Kim JS. Adenocarcinoma arising in gastric heterotopic pancreas: a case report. J Korean Med Sci. 2004;19:145–148.PubMedPubMedCentralCrossRefGoogle Scholar
  66. 66.
    Sun Y, Wasserman PG. Acinar cell carcinoma arising in the stomach: a case report with literature review. Hum Pathol. 2004;35:263–265.PubMedCrossRefGoogle Scholar
  67. 67.
    Jain D, Eslami-Varzaneh F, Takano AM, et al. Composite glandular and endocrine tumors of the stomach with pancreatic acinar differentiation. Am J Surg Pathol. 2005;29:1524–1529.PubMedCrossRefGoogle Scholar
  68. 68.
    Mizuno Y, Sumi Y, Nachi S, et al. Acinar cell carcinoma arising from an ectopic pancreas. Surg Today. 2007;37:704–707.PubMedCrossRefGoogle Scholar
  69. 69.
    Kawakami H, Kuwatani M, Onodera M, et al. Primary acinar cell carcinoma of the ampulla of Vater. J Gastroenterol. 2007;42:694–697.PubMedCrossRefGoogle Scholar
  70. 70.
    Papaziogas B, Koutelidakis I, Tsiaousis P, et al. Carcinoma developing in ectopic pancreatic tissue in the stomach: a case report. Cases J. 2008;1:249.PubMedPubMedCentralCrossRefGoogle Scholar
  71. 71.
    Hervieu V, Lornbard-Bohas C, Dumortier J, Boillot O, Scoazee JY. Primary acinar cell carcinoma of the liver. Virchows Archiv. 2008;452:337–341.PubMedCrossRefGoogle Scholar
  72. 72.
    Ambrosini-Spaltro A, Poti O, De Palma M, Filotico M. Pancreatic-type acinar cell carcinoma of the stomach beneath a focus of pancreatic metaplasia of the gastric mucosa. Hum Pathol. 2009;40:746–749.PubMedCrossRefGoogle Scholar
  73. 73.
    Cardenas CM, Dominguez I, Campuzano M, et al. Malignant insulinoma arising from intrasplenic heterotopic pancreas. Jop. 2009;10:321–323.PubMedGoogle Scholar
  74. 74.
    Kusafuka K, Bando E, Muramatsu K, et al. Pancreatic-type mixed acinar-endocrine carcinoma with alpha-fetoprotein production arising from the stomach: a report of an extremely rare case. Med Mol Morphol. 2009;42:167–174.PubMedCrossRefGoogle Scholar
  75. 75.
    Chiaravalli AM, Finzi G, Bertolini V, La Rosa S, Capella C. Colonic carcinoma with a pancreatic acinar cell differentiation. A case report. Virchows Archiv. 2009;455:527.PubMedCrossRefGoogle Scholar
  76. 76.
    Ono F, Hiraga M, Kudo K, et al. A case of adenocarcinoma of aberrant pancreas in the jejunum. Jpn J Gastroenterol Surg. 2010;43:953–957.CrossRefGoogle Scholar
  77. 77.
    Inoue Y, Hayashi M, Arisaka Y, et al. Adenocarcinoma arising in a heterotopic pancreas (Heinrich type III): a case report. J Med Case Rep. 2010;4:39.PubMedPubMedCentralCrossRefGoogle Scholar
  78. 78.
    Xinghui Y, Xiqun W. Imaging findings of pancreatoblastoma in 4 children including a case of ectopic pancreatoblastoma. Pediatr Radiol. 2010;40:1609–1614.CrossRefGoogle Scholar
  79. 79.
    Fujiwara K, Nakahara C, Yamasaki T, Iwashita T. Adenocarcinoma of aberrant pancreas in the jejunum: report of a case. J Gastrointest Cancer. 2010;41:135–137.PubMedCrossRefGoogle Scholar
  80. 80.
    Lemaire J, Delaunoit T, Molle G. Adenocarcinoma arising in gastric heterotopic pancreas. Case report and review of the literature. Acta Chir Belg. 2014;114:79–81.PubMedCrossRefGoogle Scholar
  81. 81.
    Coyne JD. Pure pancreatic-type acinar cell carcinoma of the stomach: a case report. Int J Surg Pathol. 2012;20:71–73.PubMedCrossRefGoogle Scholar
  82. 82.
    Okasha HH, Al-Bassiouni F, El-Ela MA, Al-Gemeie EH, Ezzat R. A retroperitoneal neuroendocrine tumor in ectopic pancreatic tissue. Endosc Ultrasound. 2013;2:168.PubMedPubMedCentralCrossRefGoogle Scholar
  83. 83.
    Hamidian Jahromi A, Shokouh-Amiri H, Wellman G, et al. Acinar cell carcinoma presenting as a duodenal mass: review of the literature and a case report. J La State Med Soc. 2013;165:20-3, 25.PubMedGoogle Scholar
  84. 84.
    Adachi Y, Mita H, Takahashi H, et al. Anaplastic carcinoma possibly arising from a heterotopic pancreas. Intern Med. 2015;54:3017–3022.PubMedCrossRefGoogle Scholar
  85. 85.
    Yonenaga Y, Kurosawa M, Mise M, Yamagishi M, Higashide S. Pancreatic-type acinar cell carcinoma of the stomach included in multiple primary carcinomas. Anticancer Res. 2016;36:2855–2864.PubMedGoogle Scholar
  86. 86.
    Sharma S, Agarwal S, Nagendla MK, Gupta DK. Omental acinar cell carcinoma of pancreatic origin in a child: a clinicopathological rarity. Pediatr Surg Int. 2016;32:307–311.PubMedCrossRefGoogle Scholar
  87. 87.
    Takagi K, Yagi T, Tanaka T, et al. Primary pancreatic-type acinar cell carcinoma of the jejunum with tumor thrombus extending into the mesenteric venous system: a case report and literature review. BMC Surg. 2017;17:75.PubMedPubMedCentralCrossRefGoogle Scholar
  88. 88.
    Kim KM, Kim CY, Hong SM, Jang KY. A primary pure pancreatic-type acinar cell carcinoma of the stomach: a case report. Diagn Pathol. 2017;12:10.PubMedPubMedCentralCrossRefGoogle Scholar
  89. 89.
    Yasuda K, Cho E, Nakajima M, Kawai K. Diagnosis of submucosal lesions of the upper gastrointestinal tract by endoscopic ultrasonography. Gastrointest Endosc. 1990;36:S17–S20.PubMedCrossRefGoogle Scholar
  90. 90.
    Eisenberger CF, Gocht A, Knoefel WT, et al. Heterotopic pancreas–clinical presentation and pathology with review of the literature. Hepatogastroenterology. 2004;51:854–858.PubMedGoogle Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Irina M. Cazacu
    • 1
  • Adriana Alexandra Luzuriaga Chavez
    • 1
  • Graciela M. Nogueras Gonzalez
    • 2
  • Adrian Saftoiu
    • 3
  • Manoop S. Bhutani
    • 1
    Email author
  1. 1.Department of Gastroenterology, Hepatology, and NutritionUniversity of Texas – MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of Biomathematics and BiostatisticsUniversity of Texas – MD Anderson Cancer CenterHoustonUSA
  3. 3.Department of Gastroenterology, Research Center of Gastroenterology and HepatologyUniversity of Medicine and Pharmacy CraiovaCraiovaRomania

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