Bellows C, Haque S, Jaffe B
Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112, USA.
J Gastrointest Surg. 1998 Nov-Dec;2(6):526-32. doi: 10.1016/s1091-255x(98)80052-8.
Pure pancreatic polypeptide-containing tumors (PPomas) are quite rare. Only 20 cases have been described. In this article we report a 75-year-old woman with such an endocrine islet cell tumor. The patient had no specific symptoms that could be ascribed to the tumor. An abdominal CT scan revealed a 3 cm soft tissue mass arising inferiorly from the tail of the pancreas. Local resection by way of a distal pancreatectomy was performed. A well-circumscribed hemorrhagic multiloculated mass, 3.7 cm in greatest dimension, was present in the tail of the pancreas. The patient has remained well and tumor free for the past 22 months. The endocrine characterization of the tumor was achieved by means of immunohistochemical analysis. Staining specific for insulin, glucagon, somatostatin, and gastrin was negative. In contrast, staining of the tumor for pancreatic polypeptide was strongly positive. A number of nonfunctioning islet cell tumors of the pancreas have been described. The lack of function has previously been suggested to indicate the lack of secretion of an endocrine product. This report documents that islet cell tumors may function by secreting pancreatic polypeptide but not cause symptoms.
纯胰腺多肽瘤（PPomas）相当罕见。仅报道过20例。在本文中，我们报告了一名患有此类内分泌胰岛细胞瘤的75岁女性。该患者没有可归因于肿瘤的特定症状。腹部CT扫描显示胰腺尾部下方有一个3厘米的软组织肿块。通过胰体尾切除术进行了局部切除。胰腺尾部有一个边界清晰的出血性多房性肿块，最大直径为3.7厘米。在过去的22个月里，患者情况良好，未发现肿瘤。通过免疫组织化学分析确定了肿瘤的内分泌特征。胰岛素、胰高血糖素、生长抑素和胃泌素的特异性染色均为阴性。相比之下，肿瘤的胰腺多肽染色呈强阳性。此前已描述过许多无功能性胰腺胰岛细胞瘤。以前曾认为缺乏功能表明内分泌产物分泌不足。本报告证明胰岛细胞瘤可能通过分泌胰腺多肽发挥功能，但不引起症状。
