并存的慢性胰腺炎和胰腺神经内分泌肿瘤。病例报告及文献综述。

Shrikhande S, Kleeff J, Zimmermann A, Friess H, Büchler M W

Department of Visceral and Transplantation Surgery, University of Bern, Inselspital, CH-3010 Bern, Switzerland.

Pancreatology. 2001;1(2):117-22. doi: 10.1159/000055803.

BACKGROUND

Few reports exist in the literature regarding neuroendocrine tumors either presenting as, or associated with, chronic pancreatitis. We report a case of chronic pancreatitis with a coexisting neuroendocrine tumor (gastrinoma) of the body of the pancreas. The available literature is reviewed.

METHODS

Patient data including history, surgical procedure, histology and radiology investigations were collected and summarized. A Medline search using the key words 'pancreatitis' and 'neuroendocrine tumors' was performed for the years 1966-1999. Cited references in the relevant papers not listed in Medline databases were also evaluated.

RESULTS

A 64-year-old female patient was operated on for unclear cystic lesions in the head and tail of the pancreas. Intraoperatively, a gastrinoma was incidentally discovered in the body of the pancreas. It did not appear to be obstructing the main pancreatic duct. The patient underwent a distal pancreatectomy with pancreatico-jejunostomy. Four months postoperatively, she is doing well with no signs of tumor recurrence. The Medline search revealed 125 publications, of which only 17 dealt with either acute or chronic pancreatitis associated with neuroendocrine tumors. When all available data were included, there were 26 cases of neuroendocrine tumors associated with acute pancreatitis. Additionally, 11 cases were associated with chronic pancreatitis, of which only 3 appear to be merely coexistent with chronic pancreatitis without an apparent cause-and-effect relationship between these two entities.

CONCLUSION

We report the rare co-existence of chronic pancreatitis and a neuroendocrine tumor (gastrinoma) of the pancreas. The cause-and-effect relationship between neuroendocrine tumors of the pancreas and chronic pancreatitis continues to be uncertain. However, when the etiology of chronic pancreatitis is unclear, rare neuroendocrine tumors of the pancreas might be considered. Questions remain with regard to the potential role of chronic pancreatitis in the pathogenesis of pancreatic neuroendocrine tumors.

背景

文献中关于表现为慢性胰腺炎或与慢性胰腺炎相关的神经内分泌肿瘤的报道很少。我们报告一例慢性胰腺炎合并胰腺体部神经内分泌肿瘤（胃泌素瘤）的病例，并对现有文献进行综述。

方法

收集并总结患者的病史、手术过程、组织学和放射学检查等数据。在1966年至1999年期间使用关键词“胰腺炎”和“神经内分泌肿瘤”进行了医学文献数据库检索。还评估了医学文献数据库中未列出的相关论文中的参考文献。

结果

一名64岁女性患者因胰腺头部和尾部不明囊性病变接受手术。术中偶然在胰腺体部发现一个胃泌素瘤。它似乎没有阻塞主胰管。患者接受了远端胰腺切除术加胰空肠吻合术。术后四个月，她恢复良好，无肿瘤复发迹象。医学文献数据库检索显示有125篇出版物，其中只有17篇涉及与神经内分泌肿瘤相关的急性或慢性胰腺炎。当纳入所有可用数据时，有26例神经内分泌肿瘤与急性胰腺炎相关。此外，有11例与慢性胰腺炎相关，其中只有3例似乎只是与慢性胰腺炎并存，这两个实体之间没有明显的因果关系。