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外科治疗胰腺实性假乳头状瘤4例报告(1)
http://www.100md.com 2013年3月15日 《上海医药》 2013年第6期
     摘 要 目的:探讨胰腺实性假乳头状瘤的临床表现、诊断、外科治疗及预后。方法:收集我院2011年1月至2012年10月间4例胰腺实性假乳头状瘤患者的临床资料,就其临床表现、诊疗措施以及随访预后进行回顾性分析总结。结果:4例患者平均年龄为28.8岁;3例为女性,1例为男性;3例为体检时无意间发现,1例有腹痛症状;术前影像学检查均发现胰腺囊实性肿块,各项肿瘤标记物血清学检测指标无明显特异性。肿瘤位于胰头1例,胰体尾部3例,4例均接受了胰腺部分切除,1例实施了保留十二指肠胰头,3例实施了胰体尾切除术,其中1例实施了脾脏切除手术,术后均未进行放、化疗治疗。4例术后随访6~22月,患者均存活,未发现肿瘤转移或复发。结论:胰腺实性假乳头状瘤是一种好发于青年女性的胰腺低度恶性肿瘤,预后良好,通过适当的外科治疗可以治愈。

    关键词 胰腺实性假乳头状瘤 外科手术 病例报告

    中图分类号:R657.5 文献标识码:B 文章编号:1006-1533(2013)06-0035-04

    The report of four cases of the

    solid-pseudopapillary tumor of the pancreas treated by surgery

    WANG Shi, XIA Yijun

    (Department of Hepato-Pancreato-Biliary Surgery, Inner Mongolia Peoples Hospital, Hohhot 010010, China)

    ABSTRACT Objective: To evaluate the clinical presentations, diagnosis, surgical treatment and prognosis of the solid-pseudopapillary tumor of the pancreas (SPT). Method: Four cases with SPT were collected in our hospital from January 2011 to October 2012, and their clinical manifestation, diagnosis methods, and the follow-up prognosis were reviewed. Result: The age of four patients were 22-36 years old, whose mean age was 28.8 years. Among them, three were female, and one male. Three cases were diagnosed as SPT inadvertently in our institution physical examination and one had abdominal pain symptom. The preoperative imaging examination all found solid pseudopapillary tumour of pancreas and serological examination of various tumor markers had no obvious specificity. The one tumor located in the head and other three in tale. Four cases all had received partial pancreatectomy, among which one patient preserved duodenum and pancreatic head, three underwent distal pancreatectomy, one of which had spleen resection. None of the patients received radiotherapy and chemotherapy. The follow-up of four cases ranged from 6 to 22 months. All patients survived and no evidence of relapses and metastasis were found. Conclusion: The solid-pseudopapillary tumor of pancreas is predilection in young women which is a low grade malignant pancreatic tumor and its prognosis is excellent. The appropriate surgical therapy can cure it.

    KEY WORDS solid-pseudopapillarytumor of pancreas; surgery; case reports

    胰腺实性假乳头状瘤(solid-pseudopapillary tumor of pancreas, SPTP)是一种低度恶性的胰腺肿瘤,其组织来源尚不明确。现就我院2011年1月至2012年10月收治的4例胰腺实性假乳头状瘤的临床表现、诊断措施、外科治疗及预后进行总结分析。

    1 临床资料

    病例1:患者,女,23岁,既往体健,因体检发现胰腺尾部肿瘤10 d入院,体格检查未见异常。各项血清肿瘤相关指标包括甲胎蛋白(AFP)、癌胚抗原(CEA)均在正常范围内,糖类抗原-125(CA-125)27.36 U/ml,糖类抗原19-9(CA19-9)60.3 U/ml。腹部B超提示胰尾部实性肿块,约4.8 cm×4.2 cm大小。腹部CT扫描证实胰腺尾部直径约4 cm的肿块,内部密度不均匀,包膜完整,增强后见不均匀强化。无明显肿瘤转移或后腹膜淋巴结转移的征象。CT初步诊断为胰腺尾部肿瘤,实性乳头状瘤可能性大。

    , 百拇医药(王石 夏医君)
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